Ear tubes (tympanostomy tubes, ventilation tubes, pressure equalization tubes) are tiny cylinders, usually made of plastic or metal, that are surgically inserted into the eardrum. An ear tube creates an airway that ventilates the middle ear and prevents the accumulation of fluids behind the eardrum.

Ear tubes are often recommended for children who have persistent fluid buildup behind the eardrum, especially if the condition causes hearing loss and affects speech development. Your child’s doctor may also recommend ear tubes if your child gets frequent ear infections.

Most ear tubes fall out within six to 12 months, and the holes heal shut on their own. Some tubes need to be removed, and some holes may need to be closed surgically.

How to prepare:

You’ll receive instructions from the hospital on how to prepare your child for surgery to place ear tubes.
Information to provide may include:

All medications your child takes regularly
Your child’s history or family history of adverse reactions to anesthetics
Known allergy or other negative reactions to medications, such as antibiotics

Questions to ask your doctor or the hospital staff:

When does my child need to start fasting?
What drugs can he or she take before surgery?
When should we arrive at the hospital?
Where do we need to check in?
What is the expected recovery time?
How will the anesthetic be administered — with a face mask, injection or intravenous (IV) line?

Tips for helping your child prepare include:

Start talking about the hospital visit a few days before the procedure.
Explain that the procedure will help make his or her ears feel better or make it easier to hear.
Explain that a special medicine will help him or her sleep during the surgery.
Let your child pick out a favorite comfort toy, such as a blanket or stuffed animal, that you can take to the hospital.

Results:
Ear tubes help restore ventilation and drainage of the ear. Ear tube placement often results in:

Reduced risk of ear infections
Restored or improved hearing
Improved speech
Improved behavior and sleep problems related to frequent or persistent ear infections

Even with ear tubes, your child may still get an occasional ear infection.

Usually, ear tubes stay in the eardrum for six to 12 months and then fall out on their own. Sometimes, a tube doesn’t fall out and needs to be surgically removed. In some cases, the ear tube falls out too soon, and another needs to be put in.

Article by
Fortis Healthcare

Explain that you will be there during the procedure.

Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can’t be cured, but its symptoms can be controlled. Because asthma often changes over time, it’s important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.

Symptoms:
Asthma symptoms range from minor to severe and vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

Shortness of breath
Chest tightness or pain
Trouble sleeping caused by shortness of breath, coughing or wheezing
A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

Asthma signs and symptoms that are more frequent and bothersome
Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
The need to use a quick-relief inhaler more often

For some people, asthma symptoms flare up in certain situations:

Exercise-induced asthma, which may be worse when the air is cold and dry
Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen

When to see a doctor
Seek emergency treatment

Severe asthma attacks can be life-threatening. Work with your doctor ahead of time to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:

Rapid worsening of shortness of breath or wheezing
No improvement even after using a quick-relief inhaler, such as albuterol
Shortness of breath when you are doing minimal physical activity

Contact your doctor

See your doctor:

If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time.
To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better on a daily basis and can prevent a life-threatening asthma attack.
If your asthma symptoms get worse. Contact your doctor right away if your medication doesn’t seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don’t try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse.
To review your treatment. Asthma often changes over time. Meet with your doctor on a regular basis to discuss your symptoms and make any needed treatment adjustments.
Causes:
It isn’t clear why some people get asthma and others don’t, but it’s probably due to a combination of environmental and genetic (inherited) factors.
Asthma triggers

Exposure to various substances that trigger allergies (allergens) and irritants can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
Respiratory infections, such as the common cold
Physical activity (exercise-induced asthma)
Cold air
Air pollutants and irritants, such as smoke
Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
Strong emotions and stress
Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
Menstrual cycle in some women

Prevention:

While there’s no way to prevent asthma, by working together, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.

Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan. Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life in general.
Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.
Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.
Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter.

Identify and treat attacks early. If you act quickly, you’re less likely to have a severe attack. You also won’t need as much medication to control your symptoms.

When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed and immediately stop any activity that may have triggered the attack. If your symptoms don’t improve, get medical help as directed in your action plan.
Take your medication as prescribed. Just because your asthma seems to be improving, don’t change anything without first talking to your doctor. It’s a good idea to bring your medications with you to each doctor visit, so your doctor can double-check that you’re using your medications correctly and taking the right dose.
Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn’t under control. See your doctor about adjusting your treatment.

Article By
Fortis Healthcare

What is Ulcerative Colitis?

Ulcerative colitis (UC) is a condition which involves inflammation and ulceration of the lining of the large intestine, medically called as colon. (Colitis= inflammation of colon).

The digestive system is a system of organs responsible for digesting the food we eat so that nutrients in the food are available to body to provide required energy.

The digestive system consists of a long tube, which connects the mouth to the anus. Once food leaves the mouth, it enters the part of the GI tract called the esophagus and then the stomach. In the stomach food pauses for sometime and is mixed up with acid and juices present in the stomach.

It then passes into the small intestine, which measures about 20 feet in length. The small intestine has three parts; the part nearest the stomach is the duodenum, the next part is the jejunum and the third part that connects to the large intestine is the ileum. Small intestine is the site where most of the food is digested with the assistance of secretions from the liver, gall bladder, and pancreas. The nutrients from this digested food are then absorbed through small intestine.

Followed by the small intestine is the large intestine, which is more frequently referred to as the colon. The large intestine (colon) is 6-7 feet in length. The first part of the colon is called the caecum and the appendix is found there. The caecum and appendix are situated in right lower portion of the abdomen. Large intestine then extends upward (this portion being called as ascending colon), then takes a turn and passes across (portion called as transverse colon) and then goes down wards (descending colon). At the end of descending colon, portion of large intestine which look like alphabet S is called as sigmoid colon which opens into rectum. The main function of the colon is to absorb water from the processed food residue that arrives after the nutrients have been absorbed in the small intestine. The last part of the colon is the rectum, which is a reservoir for feces. Faeces are stored here until a bowel movement occurs.

The patients of ulcerative colitis have swelling along with ulcers located in their colon and rectum.

Broadly speaking ulcerative colitis is included under an umbrella term called as inflammatory bowel disease (IBD). IBD is a term referring to the diseases that cause chronic inflammatory condition of digestive tract. Another condition included under this category is Crohn’s disease. Crohn’s disease can cause inflammation similar to ulcerative colitis anywhere in the digestive tract from the mouth to the rectum, but more commonly it attacks the small intestine in contrast to ulcerative colitis, which attacks mainly the large intestine.

Types of Ulcerative Colitis:

The inflammation related to ulcerative colitis usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. Ulcerative colitis rarely affects the small intestine except for the lower section, called the ileum. Depending upon which portion of intestine is most affected by UC, it is put under various types as follows.

Inflammation of
Entire colon =Pan-colitis (pan =entire, colitis=inflammation of colon)
Rectum= Proctitis
Sigmoid colon (S shaped portion of colon located just above the rectum) = Sigmoiditis
Beyond sigmoid colon= Left-sided colitis

Pathology:

Inside the large intestine, the inflammation of the inner lining (mucosa) causes death of the colon lining cells and this results in sores or ulcers. Also the inflammation makes the colon to empty frequently resulting in diarrhea. As the lining of the colon is destroyed, ulcers form releasing mucus, pus and blood.

Nature of the disease:

Ulcerative colitis is a chronic disease and is notorious for its waxing and waning nature.

Usually the patients of ulcerative colitis have alternating periods of relative health where the patient is symptom-free or experiences very mild symptoms (remissions) alternating with periods of active disease (relapse or flare).

Fortunately, as treatment has improved, the proportion of people with continued symptoms appears to have diminished significantly.

How common is the condition:

Ulcerative colitis is a global condition affecting people world over. It is estimated that in Unites states alone there are about one million people who suffer from some form of IBD. About half of the people with IBD have ulcerative colitis; about half have Crohn’s disease.
Ulcerative colitis affects people of all ages, but at large it is the disease of young adults. Most cases of UC are diagnosed in people between the ages 15 to 40 years. However, children as small as few months old and older people sometimes develop the disease.

The incidence of Ulcerative colitis has risen with the tide of civilization. Moreover this is a disease of young people having grievous impact on their education and career.

Ulcerative colitis does not show any gender preference and affect males and females equally. It appears to run in families. Studies also consistently conclude that ulcerative colitis occurs more often within the Jewish population.

Treatments:
Ulcerative colitis being a chronic and deep-seated disease. The treatment of Ulcerative colitis has to be planned strategically on a long-term basis. Experience suggests that the cases of Ulcerative Colitis if treated using homeopathy, especially in the early stages, respond much better. Also, it is documented that the patients who have received plenty of conventional treatment do much better when additional homeopathic treatment is added.

Research proven homeopathy offers effective treatment for Ulcerative Colitis, which has been scientifically documented. Homeopathy is very safe and can be combined with the conventional treatment if required.

The Homeopathy Treatment

Dr Rajesh Shah’s Treatment for Ulcerative ColitisThe homeopathic treatment for Ulcerative Colitis on the concept of immuno-correction, using medicines which are supposed to correct the immune mechanism which is responsible for the formation of ulcerations in the colon. Homeopathy aims at immuno-modulation using the medicines which are also capable of addressing the genetic predisposition, helping the disease process at a deeper level.

Dr Rajesh Shah, M.D. has researched on various chronic diseases including Ulcerative colitis for over 22 years. His research based molecules have international patent pending. His unique treatment protocol is made available to patients world over. At this point, there are patients from 127 countries under Dr Shah’s care, which has been a world record.

The duration of treatment:

The total length of treatment varies form case to case, depending of the following factors:

Duration of Ulcerative colitis
Extent of Ulcerative colitis
Previous or current medication such as cortisone or other immunosuppressive medicines.
General health and associated diseases
One may expect a definite improvement in about four months. The total length of medication may be

anything between six months to two years or longer, depending on various parameters. Tapering of the conventional treatment can be achieved over the period of time, in coordination with a local gastroenterologist.

Why homeopathy for Ulcerative colitis?

The major benefits of homeopathy could be summarized as under:

It offers excellent treatment which has a success rate of over 70%.
It offers immuno-correction hence gives deep-level healing.
It offers long-lasting cure instead of temporary relief.
It helps to reduce (and eventually stop) need for cortisone and other medicines
It is absolutely harmless, safe and non-toxic.
It helps arrest further progress of disease and hence deterioration caused by disease.
If administered in early stage it prevents complications like joint swelling, skin and eye complication, and even chances of colon cancer.
It is possible to avoid surgery with timely administered homoeopathy medicines for ulcerative colitis.
It significantly helps to reduce the relapse and recurrence of condition. It treats the disease from root and not merely superficially.
General management:

Patients with ulcerative colitis whose symptoms are triggered by certain foods are advised to control the symptoms by avoiding foods that upset their intestines, like highly seasoned foods or milk sugar (lactose). Generally, the patient is advised to eat a healthy, well-balanced diet with adequate protein and calories. A multivitamin is often recommended to patch up with loss of nutrients in various forms associated with ulcerative colitis. Moreover, emotional support from friends and family may help reduce the stress and its consequent repercussions on the course of disease.

Veneers Dental:

Veneers, often called teeth veneers are the materials thin in size, placed over the teeth so as to mainly improve an aesthetic oral appearance and to save the teeth from any further damages. In this procedure, a small amount of tooth enamel is removed with the veneer then being applied on. While they give the best natural look to our teeth, they also provide great strengths and resilience to them. Dental Veneers are primarily the customized tooth-shaped and colored shells that can go over our teeth; matching their size, shape and color.
Types of Dental Veneers

Cosmetic dental veneers are primarily made up of either of two materials – Porcelain or Resin Composites. Porcelain dental veneers are actually a white, vitrified semitransparent Ceramic material. Porcelain dental veneers have better stain-resistance than resin veneers; whereas, resin veneers are usually thinner than porcelain dental veneers; thereby requiring a very little layer of enamels to be removed while being placed.

Porcelain dental veneers is a highly sought-after dental treatment. The costs of dental veneers in India are affordable.
Types of Dental Problems – Being Mainly Solved by Veneers

Teeth that are stained/discolored
Teeth with small cracks and breaks
Teeth with tear and wear
Teeth with uneven gap/space between each other
Teeth with uneven shape or misalignment
Advantages of Dental Veneers

It is usually a minimally invasive dental treatment; requiring less shaping and filing of teeth unlike crown treatments. Apart from an enhanced oral appearance with improved smile and other facial features, they would typically give your teeth the longevity.

They would well integrate with gum tissues. The choice of veneer color makes us to have our teeth very close to natural teeth color and so are the teeth shape and size – truly, the best alternative to Cosmetic Dental Treatments!
Right Candidacy for Dental Veneers

To know the right candidacy, one would have to see their dentist to know if this treatment is right for them or not. Consulting your dentist, discussing about the most desirable cosmetic improvements and therefore the suitable dental solution will likely explain what exactly your dentist should recommend you. Otherwise, the dental veneers working just like your teeth replica are not a doubt at all!

In the neurological evaluation of weakness, we distinguish between
upper motor neuron weakness and lower motor neuron weakness.

The anterior horn cells are somatotopically organized in the spinal cord.

Clinically characterized by selective involvement of muscles.
Currently there is no cure for MND, however there are medicines available to slow down the progress of the disease and manage your symptoms.
Talk to your GP before starting any complementary therapy to make sure that it isn’t harmful and is compatible with any other medicines you’re taking.

Stem cell treatment introduces new cells into the damaged tissue to treat disese or injury.Stem cell treatment have the potential of changing the face of human disease and alleviate suffering.Medical researches beleive thatadult and embryonic stem cells will soon be able to treat diabetes,cancer,cardiac failure,coeliac disese,parkinsons disease.Anterior horn cell is a disease which affects the nerve cells of the spinal cord.This disease has no treatment but recent development in stem cell therspy has opened up a avenue to replace the lost neural cells by stem cells.You cant talk about reactions because it comes when no other treatment remains and is the only option.

Anterior horn cell diseases.
Clinically characterized by selective involvement of muscles. EMG
findings are those of low CMAP amplitudes (fewer axons firing muscle fibers), normal SNAP amplitudes
(ventral horn cell axons are not sensory), relatively normal nerve conduction velocities (normal axons
camouflage dead ones), large “neurogenic” MUPs (normal axons take over muscle fibers of dead ones),
muscle histology shows type grouping and group atrophy (normal axons take over muscle fibers of dead
axons [type grouping] and then eventually die [group atrophy] and blood CK is normal (CK levels
become elevated if a muscle fiber breaks down, or if the muscle membrane becomes porous. Both
conditions allow CK to leak from the muscle fiber into the blood. In neurogenic atrophy (of anterior
horn cell or peripheral [axonal] nerve origin) the muscle membranes remain intact and thus CK levels
remain normal). Fasciculations (grossly) and fibrillations (only upon needle exam) are present.
Peripheral nerve diseases.
Clinically characterized by the associated findings of sensory and autonomic
abnormalities. EMG findings depend on whether it is primarily an axonal (axon cylinder) or
demyelinating neuropathy. Axonal EMG findings are those of low CMAP amplitudes (fewer axis
cylinders in a nerve means fewer muscle fiber firing), lower SNAP amplitudes if axons in a sensory
nerve, relatively normal nerve conduction velocities (normal axons camouflage dead ones), large
“neurogenic” MUPs (normal axons take over muscle fibers of dead ones), muscle histology shows type
grouping and group atrophy (normal axons take over muscle fibers of dead axons [type grouping] and
then eventually die [group atrophy] and blood CK is normal. Fasciculations and fibrillations are present.
105
Spinal cord
Weakness
Demyelination
The EMG findings are those of relatively normal CMAP amplitudes (axis cylinders
are fine, so normal number of muscle fibers are activated), normal SNAP amplitudes (axis cylinders
are OK), reduced nerve conduction velocities (myelin loss=slowing), normal MUPs (axis cylinders
are OK), muscle histology is normal (axis cylinders are OK) and CK is normal (no muscle fibers are
dead!). No fasciculations or fibrillations.
You might wonder why normal myelinated fibers don’t camouflage the diseased fibers. In reality,
demyelinating neuropathies affect multiple focal areas of every nerve and you have normal segments
in between. Thus, you do not find “normal” and “abnormal fibers”, all the fibers are affected to
some degree. In axonal neuropathies some fibers are affected, others not. The normal fibers
conduct normally and thus you do not see significant slowing of nerve conduction velocities, but you
see drop in the SNAP and CMAP amplitudes.
Neuromuscular transmission defects.
Clinically characterized by abnormal fatigability; EMG
shows normal nerve conduction velocities, normal CMAP and SNAP amplitudes, decremental
CMAP responses to repetitive nerve stimulation; muscle histology is relatively normal; blood CK is
normal. No fasciculations or fibrillations.
Primary muscle diseases. Clinically specific patterns of muscle weakness may be noted; EMG shows
normal nerve conduction velocities with low CMAP amplitudes (fewer muscle fibers per motor
unit), normal SNAP amplitudes, smaller “myopathic” MUPs, muscle histology shows myopathic
changes; blood CK is elevated. Fibrillations are seen.
“SPEED PLAY”
Increased reflexes in a symptomatic limb suggest a central lesion, while reduced reflexes
suggest a peripheral lesion.
Bilateral sensory and motor deficits throughtout the body below a roughly horizontal level in
the trunk, with normal function above that level, indicates a spinal cord lesion

Aesthetic Dentistry:

However, if you suffer from tooth loss, stained/yellow teeth or crooked teeth, smiling can be an unpleasant experience.Tooth loss can be an embarrassment and it’s unfortunate when people do not know how simple it can be to fix.

Take a look in the mirror and imagine a bright, sparkling smile. I’ll bet it would make you look and feel at least 10 years younger. With the latest advancements in the dental field, this doesn’t have to remain an imagination anymore. Thanks to developments in the field of cosmetic dentistry, people can change the smile they were born with; into a smile they love.

There are a variety of cosmetic procedures to improve patients’ smiles. These include cosmetic procedures include short term solutions such as bleaching, bonding, reshaping, contouring, etc and long term solutions including orthodontia, implants, surgical corrections, etc.

Bleaching is a common and popular procedure that is used to whiten teeth and can be performed by a dentist in the office or under supervision at home.

Veneers are a thin layer of ceramic or porcelain that is bonded to the front of your teeth to cover stains, chips, spaces and other imperfections.

Bonding is the use of tooth colour material to fill in the gaps or change the colour of the teeth.

Tooth reshaping or recontouring are used to alter the length,shape or position of the teeth and are generally ideal for patients with normally , healthy teeth seeking subtle changes in their smile.

Dental implant is a metal screw that is placed into the jaw bone in the same area where the roots of your teeth once were. They can be used to anchor crowns , bridges and dentures.

Article By
Apollo White Dental

Root canal treatment is done for retrieve infected teeth permanently. Root canal treatment is a dental procedure where the infected or damaged pulp of a tooth is removed and the inside areas are filled and sealed. Little or no discomfort is there and the procedure is performed in either single visit or multi visits.

Root canal treatment saves the teeth that would otherwise need to be extracted. The most common cause of pulp infection is a cracked tooth or a deep cavity. They let in bacteria to the pulp and cause infection inside the tooth. If not treated, pus builds up at the root tip in the jawbone forming a “pus-pocket” called an abscess, which can cause damage to the bone around the teeth.

No preparation is needed for root canal treatment. Once the tooth is opened to drain, the dentist may prescribe an antibiotic. With the infection under control, local anaesthetic is more effective, so that the root canal treatment may be performed without discomfort.

Jaw Deformity Correction:

Orthognathic surgery or corrective jaw surgery

The size and position of face bones, jaws and teeth determine the facial appearance. If the jaws are not proportionate or out of alignment, it may cause difficulties in speaking, biting, chewing or breathing, jaw joint pain and affect the appearance. Such imbalances can be easily corrected surgically.

Orthognathic surgery is basically surgery performed on the bones of the jaws to change their position and size. It involves repositioning all or part of the upper or lower jaw or chin in alignment. Sometimes, bone may be added, taken away or reshaped. When the jaws are moved forwards or backwards, up or down, or rotated, the soft tissue in the chin, cheeks, lips and tip of the nose move accordingly. Therefore, once the jaws are correctly positioned, the architecture of the facial skeleton is changed and a harmony between the facial features is achieved. This results in a facial profile that is pleasing or in fact even more beautiful to look at.

If the upper jaw is comparatively bigger than the lower jaw, it may lead to a “gummy” smile. Excess gum tissue may be visible which may deflect from the beauty of the smile. This disparity in the size and shape of the jaw bones can be corrected by Orthognathic surgery. The jaw size is decreased and the jaw is placed in a normal position drastically improving smile and appearance.

The shape of the nose is influenced by the shape of the upper jaw. Sometimes, the sharpness of the nose is not apparent because the upper jaw is too big and protruding. In such cases, correcting the shape, size and position of the upper jaw also results in giving the nose a sharp pristine look. More severe variations in the shape of the nose can be corrected along with jaw correction in the same surgical procedure.

Before deciding the line of treatment, a detailed assessment and analysis of the face & facial bones needs to be done. Many a times, there is often a short period of orthodontic treatment done for subtle and fine detailing of the tooth positions.

The advantage of orthognathic surgery is that immediate results are seen. Also since these surgeries are approached from inside the mouth there are no visible external scars.

Jaw correction surgery brings the teeth and jaws into proper position for better health and appearance. For some patients, the surgery can dramatically enhance appearance and self esteem. Such surgeries hold the key for youngsters who go through a lot of psychological stress over their facial appearance.

Dr. S.M. Balaji is a world-renowned Facio-Maxillary Surgeon and has performed more than 20,000 surgeries in the last two decades. His expertise and skill in jaw correction surgery or orthognathic surgery is unsurpassed. Jaw surgeries are very complicated and require extraordinary precision and presence of mind.

Article by

Dr.Balaji Dental Clinic, Chennai

What is cleft lip and cleft palate?

Cleft lip and palate are facial birth deformities. A cleft lip is a gap or discontinuity in the upper lip. A cleft palate is an opening in the roof of the mouth, which divides the mouth and nose. Clefts result from incomplete development of the lip and/or palate in the early weeks of pregnancy. It is during this time that the face is being formed. Separate plates of bone and tissue gradually move towards each other and join to form the lip and palate. When these parts do not join completely, it results in a cleft.

Occurrence and causes of cleft lip and palate

On an average, one in every 700 children worldwide is born with a cleft. It is the fourth most common birth defect, and the first most common facial birth defect.
Causes

Genetic factors: Sometimes a cleft can be genetic. The risk may be higher for children whose sibling(s) or parents have a cleft or who have a history of cleft in their families. Consanguineous marriage (marriage between close relatives or cousins) can also be a cause.

Environmental factors: Not all birth deformities are hereditary. Even in the absence of any genetic factors, there are some external factors that may result in cleft formation.

1. Maternal exposure to smoking, use of tobacco, illicit drugs or alcohol consumption during pregnancy is extremely harmful for the developing baby.

2. Certain medications like steroids and others as those prescribed for Seizures, Cancer, Arthritis, Tuberculosis etc have been linked to the development of a cleft. Harmful medications and erratic dosages taken without consulting a doctor may have detrimental effects on the foetus. Women taking oral contraceptive pills unaware of their pregnancy may also contribute to clefting.

3. Studies have shown cleft is also related to advanced maternal age and also to some hormone deficiencies and dietary deficiencies namely that of folic acid, iron, iodine and zinc.

4. Cleft lip and cleft palate may also occur as a result of exposure to viruses or infectious diseases like measles while the fetus is developing in the womb.

5. Exposure to certain harmful chemicals, vapours, pesticides, gun powder fumes, nuclear radiation, X-rays, gamma rays or dangerous reagents like in industrial workplaces have dangerous effects on the genetic composition and growth of the developing baby.

Classification of Cleft Lip and Palate

1. Cleft can occur either in the lip, palate or both. The cleft of both the lip and palate mostly involves the upper alveolar (teeth bearing portion of the jaw) bone.

2. A cleft lip can be either unilateral (one-side only) or bilateral (both sides).

3. Cleft lip can either be incomplete (mild notching of the lip) or complete (large gap from lip to nose).

4. Cleft palate can either be Cleft of the Hard Palate- cleft in bony portion of roof of the mouth, Cleft of the Soft Palate- in the soft, muscular part of the palate, behind the hard palate or Cleft of both the Hard and Soft palates including the Uvula (soft tissue projection from middle of soft palate).

Submucous Cleft Palate – This cleft occurs in the tissues beneath the mucous membrane that covers the palate. Hence it is often called the “invisible cleft”. This cleft is detected only when the child has a difficulty in speaking.
Treatment for cleft lip and cleft palate:

Primary lip repair

The main concern is creating a lip seal to enable the child to suck milk. But before the child is healthy enough to undergo the surgery, a feeding plate may be given to prevent aspiration of milk from the mouth to the nose, through the gap in the palate (roof of the mouth). Specially designed feeding bottles may also be used to help in feeding

Article By
Balaji Dental & Craniofacial Hospital, Chennai.

Specialised Trauma Care Center

Whether the result of an accident or sports-related injury of the face or mouth, trauma can significantly change your appearance and can make breathing and eating difficult. Dr. Balaji is an expert in treating facial fractures and can repair most of these injuries through the mouth, eliminating visible scars.

Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries require special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.

Facial trauma can range between minor injury to disfigurement that lasts a lifetime. The face is critical in communicating with others, so it is important to get the best treatment possible. In some cases, immediate surgery is needed to realign fractures before they heal incorrectly. Other injuries will have better outcomes if repairs are done after cuts and swellings have improved.

Pediatric facial trauma differs from adult injury because the face is not fully formed and future growth will be a factor in how the child heals and recovers. Certain types of trauma may cause a delay in the growth or further complicate recovery. Difficult cases require surgeons with great skill to make a repair that will grow with your child.

New technology, such as CT scans and 3D CBCT scans have improved surgeons’ ability to evaluate and manage facial trauma. Balaji Dental and Craniofacial hospital uses the 3D Cone Beam CT (3D CBCT) scan- the latest technology in Maxillofacial Imaging. This enables accurate and detailed imaging of facial fractures and that too with a much reduced radiation exposure than conventional CTs. With these modalities under a single roof here, we provide immediate diagnosis and efficient treatment.

Our twin operation theatres are equipped with ultra-modern equipments for the safety of our patients. We have an infection free zone in our operation theatres to cater to dental and facial surgery needs. We follow strict infection control measures and microbiological monitoring protocols.

We have the latest and safest machines including advanced fiberoptic endoscope – a sophisticated anesthesia administration method. Some patients have very limited mouth opening either due to Craniofacial defects, very small jaws or retruded chins. Such patients cannot be subjected to general anesthesia in the traditional way. The flexible Fiberoptic Intubation Endoscope (FFI) is a boon in such instances.

FFI is a most powerful technique for efficient easy intubation of “difficult laryngoscopy” patients otherwise impossible to intubate during general anesthesia.