Daijiworld Media Network - Udupi (JD)
With Inputs from Media Release

Udupi, Nov 30: In yet another medical feat, KMC Manipal has performed two unique surgeries to give a new lease of life to two young men.

In the first case, the doctors at KMC conducted a surgery of joint replacement on a distracted mandible. Aman (name changed), a 21-year-old youth who hails from a small village in Karnataka lived a shy life as he was unable to open his mouth from birth which had negatively affected his personality. He led a secluded life. The disability meant that Aman was too self-conscious to walk the streets, meet new people or make new friends. It had also affected his ability to thrive.

He then visited the department of oral and maxillofacial surgery, MCODS, Manipal. Dr Abhay Taranath Kamath, professor and HoD, department of MCODS Manipal said that when he first visited the department Aman came across as a very shy individual who was reluctant to talk or interact with anyone as he had no mouth opening. With difficulty in chewing the food as well as significant obstructive sleep apnea (obstructive sleep apnea is a serious sleep disorder which causes breathing to repeatedly stop and start during sleep) his health had also suffered and he appeared very frail and malnourished.

A treatment plan was formulated where in it was decided that a total temporomandibular joint replacement would be performed on a distracted mandible, with the treatment plan divided in two phases. In the first phase the patient would undergo distraction osteogenesis for his small jaw and small chin to overcome his sleep apnea and later on in the second phase he would undergo release of his joint fusion and simultaneous jaw replacement, which would give him a good mouth opening and good facial appearance.

The procedure of performing total joint replacement on a distracted mandible in patients with TMJ ankylosis using biomet stock prosthesis is the first reported case in India.

As the financial condition of the patient was not good, treatment was conducted free of cost.

In the second case, a tumor of mandible was treated successfully by the KMC doctors. Ravi (name changed), aged 20, had undergone maxillofacial surgery for a tumor removal in his right lower jaw including removal of the lower jaw as well, at Kasturba Medical College and Hospital, Manipal by the department of oral and maxillofacial surgery, MCODS, Manipal, around 3 years ago. Since then the patient has been disease free, however, the psychological stigma of losing a portion of the face had taken a toll on the youth. He had stopped moving around in public, the parents of the boy had visited the department of oral and maxillofacial surgery, MCODS Manipal, and after discussing with Dr Abhay T Kamath, it was decided to replace the lower right jaw with titanium made implant specifically made for this case (patient matched implant).

Usually in this situation a part of the leg bone is removed and replaced in place of small jaw. But as the patient was a bodybuilder, it would have hindered his career, so the doctors opted for patient matched implant, wherein a new small jaw was created according to the exact size of the existing jaw in the mouth. The new jaw was created in Florida, America.

The procedure of performing patient matched implant is the first reported case in India.

"Both the patients are satisfied with the treatment and are happy. We thank all those who supported Aman’s surgery by providing financial assistance," said Dr Abhay Kamath.

Both the surgeries were performed by Dr Abhay T Kamath, who has undergone extensive training in TMJ replacements under Dr David Psutka in Toronto, Canada, and his team comprising Dr Adarsh, Dr Srikanth, Dr Chitra, Dr Sunil and Dr Anand. The surgical procedure was uneventful with the patients achieving good dietary scores and mouth opening. Dr Anitha Nileshwar, professor and head, department of anesthesia, KMC, Manipal and Dr Manjunath, professor of department of anesthesia, KMC, Manipal provided the anesthesia cover for both the cases. The surgical outcomes has made the patients more confident and has bought back their missing smile. The surgery has not only transformed the faces of the patients but also changed their lives.

Dr (Col) M Dayananda, medical superintendent of Kasturba Medical College and Hospital, Manipal, said, "We are proud to have advanced dental surgeries done at Kasturba Hospital, that too for their first time in country. Congratulations to Dr Abhay Kamath and his dedicated team and also to Manipal College of Dental Sciences."

Dr Keerthilatha M Pai, dean, Manipal College of Dental Sciences was present at the press meet.