Sagaya Fernando Mumbai: 6 November 22 A team of doctors at Apollo Multispecialty hospital in Triuchirappalli, Tamil Nadu, India, saved the life of a 33-years-old man whose neck was pierced through by a feet long iron rod. Karthikeyan, a resident of Ariyamangalam in the city, was watering the concrete slabs on the first floor of his under-construction house when he accidentally slipped and fell 15 to 20 feet down, on October 15. As he fell, a 5 feet long iron rod with serrated edges pierced through his neck and came out from the back. “Within fifteen minutes of the mishap, his relatives rushed him to our hospital which is in close vicinity,” informed Apollo Multispecialty Hospital, Triuchirappalli, Consultant General, Laparoscopic and Bariatric Surgeon Dr Mohamed Mansoor, who led the operating team. “On evaluation in emergency, it was seen that he had a 5 feet long iron rod penetrating into the anterior aspect of neck and exiting the posterior aspect of neck.
Rare surgery helps man to open mouth and eat solid food after 38 long years
Story by Sagaya FernandoMumbai: 15th March 2018
A mishap when he was barely one year old in the year 1979, left 39-year-old Rajendra Panchal of Pune in the state of Maharashtra in India, not only with a very narrow mouth but also turned him into an introvert after facing taunts for his facial looks from those around him. With barely able to open his mouth, Rajendra had been living on a liquid diet for the past 38 years till a chanced visit to a dentist for a severe toothache set him on a chain of action, culminating in a rare surgery to open his mouth and enable him to eat solid food after 38 long years.
Oral and Maxillofacial Surgeon Dr. J B Garde who conducted the corrective surgery on Rajendra says, “It is a rare case seen 1 in 25 lakhs. However, normally in such cases it is diagnosed and treated without much delay. But, here, the patient has persisted with the condition for 38 years, making it even more extremely rare.”
Ever since the mishap, Rajendra gradually developed a gradual closure of the mouth which resulted in an absolute inability to open it. The severity of his condition was such that Rajendra was unable to chew and remained on a liquid and semi-solid diet, rendering him malnourished. “Our financial condition was such that we cannot afford medical treatment. Also, I had to drop out of school after fourth grade due to our poor socio-economic status,” reminisces Rajendra who works as a helper earning a meager salary.
Unable to bear a severe toothache in December last year, he visited the dental clinic run by Dr. Garde, who after a thorough clinical examination realised that Rajendra had absolutely no ability to open his mouth and that it was impossible to reach the tooth. In medical terms, Rajendra was suffering from a deformity of the temporomandibular joint (TMJ) ankyloses. In such cases, the joint of the face is fused to the skull and patients may even require a complete joint replacement. TMJ Ankylosis is a rare condition which requires a skillful surgical procedure.
Dr. Garde who conducted the surgery on Rajendra said, “Most cases of ankylosis are reported due to trauma or ear infections. The procedure to release the fused skull bone is a complex one and post-operative physiotherapy sessions play a vital role for such patients. There are also high chances of re-ankylosis in patients if they skip the physiotherapy sessions.”
“I diagnosed the condition and after coming to know about his socio-economic status, conducted the surgery free of cost which otherwise would have cost him Rs 4 lakhs to Rs 5 lakhs,” said Dr. Garde.
The surgery took place on 21st December 2017, and Rajendra was discharged on January 5.
“The surgery lasted more than four hours, during which his fused skull bone was released and we achieved a satisfactory opening in the mouth of 45 millimetres,” said Dr. Garde, adding that the patient has recovered well and is able to ingest solid food, besides being able to talk clearly.
“I am now able to eat and talk like any normal person,” said an elated Rajendra.
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