Ameloblastoma Surgery on a Tanzanian Patient

SIMS Hospital gives a new lease of life to a 38-year old Tanzanian affected by ameloblastoma

Ends his 14 year old misery of pain, functional discomfort and social stigma in 14 days

The Chennai based SIMS (SRM Institutes for Medical Science) Hospital, one of the leading super speciality quaternary care hospitals in Tamil Nadu, puts an end to a thirty-eight year old Tanzanian patient’s pain and misery of 14 years caused by more than 1 kg weighing Ameloblastoma in the lower jaw. Lack of early medical intervention and diagnostic facility in his country, made it difficult for him to even chew and eat his food, which in turn affected his overall quality of life significantly. With defective and continuously increasing lump on the jawbone, the Tanzanian patient was referred to SIMS, Vadapalani, Chennai by his Government for a holistic treatment.

Speaking on the medical condition and the technical procedure followed during the treatment, Dr. K. Sridhar, Head-Craniofacial, Aesthetic and Plastic Surgery, SIMS, said, “Our first assessment revealed a huge ball sized tumour that was causing severe pain, swelling and facial deformity for the Tanzanian patient. With initial screenings through, we diagnosed the lump to be ameloblastoma that required complex surgical correction given its unusual size. During the initial virtual observation, assessment we took into consideration and carefully evaluated the key parameters including the size of tumor, the length of fibular graft needed,And the shape of graft for precise calculations and further procedure. For, these are the parameters that will determine the restoration of his oral function and appearance.

It required a reconstruction of the entire mandible including both the sides of the jaw. This necessitated a 4 piece reconstruction having different angulation and dimension. A complex virtual planning in computer was required to have a final result for a natural appearance.

This required a team approach having reconstructive plastic surgeons, maxillofacial surgeons, specialists in implantology and a computer engineer, apart from highly skilled Aneasthesia team.

“Thus began the whole treatment process of transferring a virtual plan to clinical operation with a holistic approach to help that Tanzanian patient regain his normal life, to eat well, become more socially acceptable sans the stigma. The meticulous preparation with the key advanced 3-Dimensional CT techniques of medical image processing and printing, planning of tumor resection, and fibular resection for graft harvesting, graft shaping, and fixation, as well as planning, designing and fabrication of the templates for clinical realization of the plan, all were being discussed to the last details. Such fabricated virtual model significantly improves the quality and efficiency of the surgery, with less time-consumed at the operation theatre and the patient satisfaction with both the recovery of oral function and appearance’.

CTO ( Chronic Total Occlusion in Coronary arteries) WORKSHOP

“CTO ( Chronic Total Occlusion in Coronary arteries) WORKSHOP” organized at SIMS HOSPITAL, Vadapalani on behalf of Institute of Cardiac sciences by Dr. Srinath Sainathan, Senior Interventional Cardiologist today.

Senior Japanese CTO operator was invited to perform some CTO cases, which were done successfully.

This was followed by CME talk and discussion on interesting CTO cases by the senior faculty.

Astigmatism

Astigmatism is a common vision problem caused by a corneal-shaped error. With astigmatism, the eye lens or cornea, which is the front surface of the eye, has an irregular curve. This may change the way light passes, or refracts, to your retina. This causes blurred, blurred, or distorted vision. Farsightedness and short-sightedness are two common forms of problems with the way light passes through your retina. This is termed hyperopia. Near-sightedness is called myopia.

Who is at risk for astigmatism?

Astigmatism can occur in children and adults. Your risk of developing astigmatism may be higher if you have one of the following:

  • A family history of astigmatism or other eye disorders, such as keratoconus.
  • Thinning of your cornea
  • Excessive nearsightedness.
  • Excessive farsightedness.
  • A History of certain types of eye surgery, such as cataract surgery.

What are the symptoms of astigmatism?

The symptoms of astigmatism can vary from person to person. Many may have no symptoms at all. Symptoms of astigmatism include the following:

  • Blurry, Distorted, or fuzzy vision at all distances.
  • Difficulty seeing at night
  • Eyestrain
  • Squinting
  • Eye irritation
  • Headaches

See your doctor if you have signs of astigmatism. Many signs may also be due to other issues with your health or vision.

Astigmatism Treatment

Glasses or contacts may correct almost all cases of astigmatism. But if you have a mild astigmatism and no other vision problems, you may not need them.

There are two treatments for the common levels of astigmatism:

  • Corrective lenses.That means a glass or a touch. If you have astigmatism, your doctor will probably recommend a special type of soft contact lens called toric lenses. If your case is more serious, you may have gas-permeable rigid contact lenses for a procedure called orthokeratology. You’re wearing your glasses when you sleep, and they’re reshaping your cornea.
  • Refractive surgery. Laser surgery also changes the shape of your cornea. Types of refractive surgery include LASIK and PRK.

Irregular astigmatism is far less common and is associated with problems with your cornea, the front part of the eye.

Aphakia

Aphakia is a disease that doesn’t require an eye lens. The lens of your eye is a transparent, flexible structure that helps your eye to be focused. The condition is most common in adults with cataracts, but it may also affect infants and children.

What are the symptoms of Aphakia?

The main symptom of aphakia is the absence of a lens. This may lead to other signs, such as:

  • Blurry vision
  • Trouble focusing on objects
  • Changes in color vision, which involves colors appearing faded
  • Trouble focusing on an object as your distance from it changes
  • Farsightedness, or trouble seeing things up close

How is Aphakia treated?

Treating aphakia usually involves surgery for both children and adults.

It is necessary to have surgery as soon as possible for babies with aphakia, since their eyes grow very quickly. We will need glasses or special contact lenses, which they can sleep in and wear after surgery for long periods of time. Once they are about a year old, they can receive an artificial lens implant.

Adult surgery with aphakia also involves removing the damaged lens if necessary, and implanting an artificial lens. Usually done using a local anesthetic, the procedure would take less than an hour. After the surgery, your doctor can prescribe contact lenses or glasses to improve your vision.

Atherosclerosis

Atherosclerosis is a disease in which plaque is formed inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to the heart and other parts of the body.

Plaque consists of fat, cholesterol, calcium and other substances found in the blood. Over time, the plaque hardens and narrows the arteries. This restricts the flow of oxygen-rich blood to your organs and other parts of your body.

Atherosclerosis may lead to serious problems, including a heart attack, stroke, or even death. The exact cause of atherosclerosis is not known. Studies, however, show that atherosclerosis is a slow, complex disease that can begin in childhood. It’s growing faster as you age.

Causes:

Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include:

  • Smoking
  • High amounts of fats and cholesterol in the blood
  • High blood pressure
  • High amounts of sugar in the blood.

Plaque may begin to build up where the arteries have been damaged. Over time, the plate hardens and narrows the arteries. Eventually, the area of the plate may rupture (break open).

Signs, Symptoms, and Complications

Atherosclerosis usually does not cause signs and symptoms until the artery is severely narrowed or completely blocked. Many people don’t know that they have a disease until they have a medical emergency, such as a heart attack or stroke.

Some people may have signs and symptoms of illness. Signs and symptoms depend on which arteries are affected.

Treatment

Treatments for atherosclerosis may include changes in heart-healthy lifestyles, medicines, and medical procedures or surgery. The treatment objectives include:

  • Lowering the risk of blood clots forming
  • Preventing atherosclerosis-related diseases
  • Reducing risk factors in an effort to slow or stop the buildup of plaque
  • Relieving symptoms
  • Widening or bypassing plaque-clogged arteries
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