Hailing from Ballari, Karnataka baby Huligemma was born with a birth defect in her face structure, Tessier facial cleft, involving upper half of the face, right eye, upper lip and palate. She required complex craniofacial reconstructive surgical procedures to restore her facial appearance, be fed well, and develop good speech. But, due to the prevailing economic condition of the family, they were unable to bear the cost of the treatment and pinned all their hopes on a miracle that could gift their child a new life.
Tessier facial cleft is a collection of related conditions that cause clefts or defects in the soft tissues and bones of the face that are more severe or follow different patterns than the common form of cleft lip and palate. Usually, babies born with this condition require corrective surgeries for proper growth, development and to look healthy. With the help of team of doctors at Aster CMI Hospital, Dr. Chetan Ginigeri, Lead Consultant – Paediatrics & Paediatric Intensive Care, Dr. Sathish M S Vasishta, Consultant – Craniomaxillofacial Surgery and Dr. V Arun, Lead Consultant – Anaesthesia & Critical Care, Dr. Gaurang J Kothari, Consultant – Anaesthesia & Critical Care and other surgeons, Huligemma underwent all the corrective surgeries and now she is leading a normal life.
Speaking about Huligemma’s case, Dr. Chetan Ginigeri, Lead Consultant – Paediatrics & Paediatric Intensive Care, Aster CMI Hospital, said, “Huligemma had a face with the cleft extending into the palate, lip, right side of the nose all the way up to the right side of the eye. She required a complex reconstructive procedure to reconstruct her facial deformities and give her a very good functional and cosmetic outcome in terms of bridging the nasal cleft. We were able to give a good reconstructive surgery by clearing her disfigurement which was made possible with the help of Craniomaxillofacial and pediatric anesthesia Team. Now she is recovering fast, able to feed well without spilling the food and milk from the nose, speak and is undergoing speech rehabilitation. She will gain weight and she will develop normally.
Self-esteem issue can crop up slightly in older children with severe cleft palate and facial deformities. This can be addressed by providing the required reconstructive surgery at a young age. Commenting on the complications involved in the surgery, Dr. Sathish M S Vasishta, Consultant – Craniomaxillofacial Surgery, Aster CMI Hospital, said, “Huligemma was suffering from a very rare condition and to give her a normal facial look, she underwent three procedures till date. She requires one more procedure for final palate correction. She underwent functional repair surgery, the first procedure when she was five months old. It took six hours to prepare the facial cleft, reconstruct the lower eye lid and re-correct part of her face. We did cleft palate surgery in the second procedure when she was 11 months old. The third procedure was bilateral cleft lip repair and was conducted when she was 15 months old. She has a residual defect in the palate as the palate was opened widely.”
Dr. V Arun, Lead Consultant – Anaesthesia & Critical Care, Aster CMI Hospital, said, “For a small child going through a major surgery under general anaesthesia is a huge challenge. Huligemma was only five months old when we did the first surgery. The presence of a large facial cleft also made it risky to maintain her airway and support her breathing during and after the surgery. This requires expertise in skill and equipment which make these rare surgeries safe for children of this age. Anaesthesia for these prolonged surgeries and intensive postoperative monitoring is key to having a good surgical outcome with minimal blood loss. Multiple anaesthesia’s for 3-4 surgeries also needs significant coordination with all the teams to make sure patient’s nutrition and care is not compromised during her stay in the hospital.
Durugamma, mother of Huligemma, said, “When I found out that I was pregnant, my husband and I were over the moon. However, during the eight months scan we came to know about the deformities. It was difficult for us. Our immediate relatives began to persecute us to abort. But my baby doesn’t deserve this. It’s not her fault. She is innocent. Then we came to Aster CMI Hospital. The doctors have been kind to us and told us about the corrective surgeries. They even showed us videos of children on the internet who were born like my baby but went on to lead normal lives after the surgery. Now she has completed all the surgeries and we are very happy to see how our daughter is leading a happy life. We thank the social organizations that have cooperated with Aster CMI on the funding and help our daughter. Also, I would like to thank all the doctors, nurses and staff for giving her a new lease of life.”