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Hemifacial microsomia

Apr 23, 2025 Posted by admin Paediatrics, Plastic surgery 0 comments

Overview

Hemifacial microsomia is the second most common facial birth defect behind cleft lip and palate, affecting one in every 3,500 to 4,000 births. Hemifacial microsomia is a congenital condition in which the tissues on one side of the face are underdeveloped. It primarily affects the ear, mouth, and jaw areas, though it may also involve the eye, cheek, neck, and other parts of the skull, as well as nerves and soft tissue. In 10 to 15 percent of cases, both sides of the face are affected, oftentimes asymmetrically.

Children with hemifacial microsomia need ongoing medical care, including multiple surgeries. But once they reach early adulthood, they likely won’t need any more procedures. Long-term follow-up may be necessary to check for issues that come back or worsen over time. Hearing aids and implants may need adjusting.

Physical challenges and the psychological effects of looking different can impact your child’s emotional health. Seeking support through counseling is essential in helping your child develop coping strategies.

Causes

Symptoms can range from mild to severe and usually involve the underdevelopment of one or more facial features. Hemifacial microsomia affects everyone differently, and the degree of involvement can vary. One of the ways clinicians describe and assess the severity of hemifacial microsomia is the OMENS classification. The OMENS classification examines the function and appearance of each of the following, looking for characteristics commonly associated with hemifacial microsomia:

  • Orbit (eye socket): small and underdeveloped eyes with impaired vision; absent or unformed eye; growths on the eye; one eye appearing smaller than the other, but with normal vision
  • Mandible (the jaw bones): underdeveloped upper and lower jaw on one side; crooked jaw; missing, misaligned or overcrowded teeth; cleft lip and/or cleft palate; limited opening or closing of the mouth
  • Ear: small skin tags; misshapen or missing external ear; absent or abnormal development of the ear canal resulting in partial or total hearing loss
  • Nerves: ranging from mild weakness to partial or full facial paralysis
  • Soft tissues (skin, muscle, fat, tendons and ligaments): flattened forehead or cheekbone, unequal cheek fullness, asymmetrical mouth with lateral cleft

Most children with hemifacial microsomia have facial anomalies but no other major medical issues. In some cases, babies born with hemifacial microsomia may also have other health problems such as malformed vertebrae, heart defects or abnormally shaped kidneys.

Diagnosis and Tests

Healthcare providers typically start with a physical exam. They usually diagnose the condition shortly after birth. In some cases, they might detect it before birth using prenatal ultrasound or MRI (magnetic resonance imaging).

Your healthcare provider may need to run additional imaging tests to diagnose hemifacial microsomia, like:

  • X-rays
  • CT scans (computed tomography scans)

Management and Treatment

Treatment for this condition depends on the severity of involvement. Children with hemifacial microsomia usually need surgery to repair or reconstruct their facial features. The type and timing of these procedures depend on your child’s needs. In infancy, the focus of treatment is to make sure your baby is breathing and feeding well. In childhood and adolescence, the goal of treatment is to improve the function and appearance of the face. It’s often necessary to delay procedures or do them in multiple stages as your child grows.

Surgical treatments

Surgical treatments for hemifacial microsomia include:

  • Ear, nose and throat surgery
  • Facial plastic surgery
  • Eye surgery
  • Maxillofacial surgery
  • Oral surgery
  • Plastic surgery

Neonatal surgery

If your newborn has breathing difficulties or is unable to nurse, your healthcare provider may treat your baby’s hemifacial microsomia immediately after birth. The most common procedures done after delivery include:

  • Tracheostomy, an incision in your baby’s neck and windpipe to aid breathing
  • Tube feeding, which gives your baby nutrition if they’re unable to nurse

Nonsurgical treatments

In addition to surgical treatments, your healthcare provider may recommend these nonsurgical therapies:

  • Braces and other teeth-straightening devices
  • Hearing aids for mild hearing loss
  • Speech therapy to address challenges with swallowing and speaking

During follow-up visits, diagnostic testing may be done. The goal of continued monitoring is to help spot any irregularities in growth or development and to address health issues as they develop, optimizing long-term outcomes for your child.

Conclusion

Hope this article finds you with informative knowledge needed, further if you come across any of your family members friends  or your loved ones with anysuch kind of disease you can guide them to us or share their latest reports via email – query@gtsmeditour.com and get the  second best opinion from our experienced doctors and treatment plan for the same.

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Intussusception – children

Dec 31, 2024 Posted by admin Paediatrics 0 comments

Overview

Intussusception is a rare, serious disorder  the sliding of one part of the intestine into another. This telescoping action often blocks food or fluid from passing through. Intussusception is the most common cause of intestinal obstruction in children younger than 3 years old. The cause of most cases of intussusception in children is unknown. Though intussusception is rare in adults, most cases of adult intussusception are the result of an underlying medical condition, such as a tumor. Intussusception also cuts off the blood supply to the part of the intestine that’s affected. This can lead to infection, death of bowel tissue or a tear in the bowel, called perforation. In children, the intestines can usually be pushed back into position with a minor procedure. In adults, surgery is often required to correct the problem.

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Causes

Intussusception is caused by part of the intestine being pulled inward into itself.

The pressure created by the walls of the intestine pressing together causes:

  • Decreased blood flow
  • Irritation
  • Swelling

Intussusception can block the passage of food through the intestine. If the blood supply is cut off, the segment of intestine pulled inside can die. Heavy bleeding may also occur. If a hole develops, infection, shock, and dehydration can take place very rapidly.

The cause of intussusception is not known. Conditions that may lead to the problem include:

  • Viral infection
  • Enlarged lymph node in the intestine
  • Polyp or tumor in the bowel

Intussusception can affect both children and adults. It is more common in boys. It usually affects children ages 5 months to 3 years.

Symptoms

Children

The first sign of intussusception in an otherwise healthy infant may be sudden, loud crying caused by belly pain. Infants who have belly pain may pull their knees to their chests when they cry.

The pain of intussusception comes and goes, usually every 15 to 20 minutes at first. These painful episodes last longer and happen more often as time passes.

Other symptoms of intussusception include:

  • Stool mixed with blood and mucus — sometimes referred to as currant jelly stool because of its appearance.
  • Vomiting.
  • A lump in the belly.
  • Weakness or lack of energy.
  • Diarrhea.

Not everyone has all of the symptoms. Some infants have no obvious pain. Some children don’t pass blood or have a lump in the belly. And some older children have pain but no other symptoms.

 Diagnosis

The health care provider will perform a thorough exam, which may reveal a mass in the abdomen. There may also be signs of dehydration or shock.

Tests may include:

Risk factors

Risk factors for intussusception include:

  • Age. Children — especially young children — are much more likely to develop intussusception than adults are. It’s the most common cause of bowel obstruction in children between the ages of 6 months and 3 years.
  • Sex. Intussusception more often affects boys.
  • Irregular intestinal formation at birth. Intestinal malrotation is a condition in which the intestine doesn’t develop or rotate correctly. This increases the risk of intussusception.
  • Certain conditions. Some disorders can increase the risk of intussusception, including:
    • Cystic fibrosis.
    • Henoch-Schonlein purpura, also known as IgA vasculitis.
    • Crohn’s disease.
    • Celiac disease.

Treatment

Treatment options for intussusception may include:

  • A water soluble contrast or air enema. This is both a diagnostic procedure and a treatment. If an enema works, further treatment is usually not necessary. This treatment can actually fix intussusception 90% of the time in children, and no further treatment is needed. If the intestine is torn (perforated), this procedure can’t be used.

    Intussusception recurs up to 20% of the time, and the treatment will have to be repeated. It is important that a surgeon be consulted even if treatment with enema is planned. This is because of the small risk of a tear or rupture of the bowel with this therapy.

  • Surgery. If the intestine is torn, if an enema is unsuccessful in correcting the problem or if a lead point is the cause, surgery is necessary. The surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died. Surgery is the main treatment for adults and for people who are acutely ill.

In some cases, intussusception may be temporary and go away without treatment.

Further, if you come across any of your friend or closed one looking for any kind of disease treatment you can share  us the latest available reports via, email – query@gtsmeditour.com or you can whatsapp the reports to us +91 9880149003 and get the second medical opinion which can help you decide to take right treatment.

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Meningitis

Feb 8, 2019 Posted by admin Neuropathy, Paediatrics 0 comments

Meningitis is deadly that it can kill in a matter of hours.Though some cases of meningitis improve without treatment,others can be life-threatening and require emergency treatment.
Meningitis occur when the fluid surrounding the meningis become infected causing inflamamtion of meningis. Meningis are three delicate protective membranes of brain and spinal cord.6.Feb8Meningitis

Causes

Meningitis is caused by bacterial,viral or fungal infection,viral infected ideas being the most common.It can also be caused by other factors such as cancer,drug irritations.Like any other infection,meningitis can be contagious too which can be transmitted through touch,sneezing etc.

Bacterial meningitis
Though it is rare,it can be fatal if not treated right away.Bacterial meningitis can cause stroke, hearing loss, and permanent brain damage.The disease can occur when certain bacteria invade the meninges directly or when  the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infectionor nasal sinus infection (sinusitis).Several bacteria can first cause an upper respiratory tract infection and then travel to brain via bloodstream.

  • Pneumococcal meningitis  is the most serious form of bacterial meningitis,caused by the bacterium Streptococcus pneumoniae.It  also causes pneumonia, blood poisoning (septicemia), and ear and sinus infections.
  • Meningococcal meningitis is caused by the bacterium Neisseria meningitides. If diagnosed, people in close contact should be given preventative antibiotics.
  • Haemophilus influenzae meningitis.

Viral meningitis
Also called aseptic meningitis ,it is usually caused by common viruses that enter the body through the mouth and travel to the brain and surrounding tissues.Many of the enteroviruses viruses that cause meningitis are common, such as those that cause colds, diarrhea and the flu.Other viruses that cause meningitis include varicella zoster (chicken pox virus),, mumps, HIV, and herpes simplex type 2 (genital herpes).

Fungal meningitis
The most common of this is caused by the fungus cryptococcus neoformans(found mainly in dirt and bird droppings).  Fungal infectionns can affect brain.Although treatable, fungal meningitis often recurs in 50 % of the affected persons.
Meningitis can affect anyone .Children,people with weakened immune systems( including persons with HIV or taking immunosuppressant drugs) are at increased risk.

Symptoms

Significant signs of meningitis are

  • sudden fever
  • severe headache
  • nausea or vomiting
  • double vision, drowsiness
  • sensitivity to bright light
  • stiff neck.

In infants ,fever, lethargy, not waking for feedings, vomiting, body stiffness, unexplained irritability, and bulging fontanel (the soft spot on the top of the head) are important signs of meningitis and should be watched for.
Distinctive rashes called meningitis rash are seen in some forms of the disease.This is one late sign of bacterial meningitis.These are faint rashes and may not be easily visible in dark skinned people.Rash will become more obvious as  infection worsen and spots grow darker. Meningococcal meningitis damages capillary cells leading to  capillary damage and mild blood leaks.
Meningitis can also cause septicaemia.It is the blood poisoning caused by the same germs that cause meningitis.It is the more life threatening form of the disease. Septicaemia can occur with or without meningitis.

Diagnosis

Early diagnosis is vital, as symptoms can appear suddenly and escalate to brain damage, hearing and/or speech loss, blindness, or even death.
Diagnostic tests include:

  • series of physical examination tests designed to assess motor and sensory function, nerve function, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior.
  • screening of blood, urine, and body secretions can help detect and identify brain and/or spinal cord infection.
  • Cerebrospinal fluid  is tapped to detect the presence of bacteria, blood, and viruses. Analysis of the fluid can also reveal infections in the brain and/or spinal cord, acute and chronic inflammation, and other diseases.

Brain imaging  is used to detect signs of brain inflammation, internal bleeding or hemorrhage.Following are noninvasive painless imaging procedures routinely used

  • Computed tomography, also known as a CT scan to produce rapid, clear, two-dimensional images of organs, bones, and tissues.
  • Magnetic resonance imaging (MRI) can help identify brain and spinal cord inflammation, infection, tumors, and other conditions.

Furthermore, electroencephalography(EEG) can identify abnormal brain and diagnose patterns that may suggest specific viral infections such as herpes virus and to detect seizures.

Treatment

Early treatment of bacterial meningitis involves antibiotics that can cross the blood-brain barrier . Appropriate and immediate antibiotic treatment for most types of meningitis can greatly reduce the risk casualties. Anticonvulsants to prevent seizures and corticosteroids to reduce brain inflammation may be prescribed.Infected sinuses may need to be drained.  Corticosteroids such as prednisone  are usually prescribed  to relieve brain pressure, swelling and to prevent hearing loss that is common in Haemophilus influenza meningitis.Viral meningitis can ease without treatment over a few weeks.Fungal meningitis is treated with intravenous antifungal medications.

Vaccination

Vaccinations offer protection against certain causes of meningitis.These include the:

  • meningitis B vaccine – offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year
  • 6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
  • pneumococcal vaccine – offered to babies at 8 weeks, 16 weeks and 1 year old
  • Hib/MenC vaccine – offered to babies at 1 year of age
  • MMR vaccine – offered to babies at 1 year and a second dose at 3 years and 4 months
  • meningitis ACWY vaccine – offered to teenagers, sixth formers and “fresher” students 

Outcome generally depends on the the severity of the illness and how quickly treatment is given.  In most cases, meningitis can make a full recovery although the process may be slow. Individuals may need long-term therapy, medication, and supportive care in more serious cases where disease has caused permanent damages like brain and nerve damage,blindness,memory loss,seizures,lack of muscle control etc