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Pioneering surgery saves newborn with PRS at Lucknow Command Hospital

In a remarkable medical achievement, the Command Hospital in Lucknow has successfully conducted a pioneering surgery on a newborn suffering from an extremely rare disorder known as Pierre Robin sequence (PRS).

 

PRS is a highly uncommon condition characterized by a significantly undersized lower jaw and a cleft palate, causing severe breathing difficulties for affected infants. Without prompt intervention, infants with such critical birth conditions often face a grim prognosis and rarely survive beyond their first birthday.

 

With an incidence rate of one in 60,000 live births, PRS frequently leads to pneumonia and other respiratory complications, making survival incredibly challenging.

 

Lucknow-Command-hospitalThe hospital recently received a case transferred from a primary healthcare facility to their specialized care unit in Lucknow.

 

The newborn, experiencing respiratory distress and struggling to thrive, required immediate attention.

 

A multidisciplinary team of specialists, led by Brigadier M. K. Rath, Consultant Maxillofacial Surgery, and comprised of Colonel Ashutosh (Neonatologist), Colonel Badal Parikh (Anesthesiologist), and Lieutenant Colonel Vishal Kulkarni (Maxillofacial Surgery), conducted a comprehensive evaluation of the infant's condition.

 

Given the child's relatively low weight and underdeveloped lower jaw, an interim procedure called lip-tongue adhesion surgery was performed. Once the infant's condition stabilized and became suitable for a major operation, preparations were made for the placement of a distractor, an instrument used to advance the lower jaw. During the procedure, the anesthesiologists employed state-of-the-art video-guided intubation techniques.

 

Using a cutting-edge surgical approach known as neonatal distraction histiogenesis, the medical team successfully elongated the baby's small lower jaw by more than 10 mm. This innovative technique, originally developed by Russian military surgeon Gavriil Ilizarov to lengthen amputated limbs of soldiers, has been adapted by maxillofacial surgeons to address mandibular issues.

 

The procedure involves creating controlled fractures on both sides of the jaw, allowing the tissue to heal for 4-5 days before gradually separating the jaw segments, thereby harnessing the body's natural regenerative potential.

 

By elongating the lower jaw, the surgery moved the tongue forward and reopened the collapsed upper airway, enabling the infant to breathe normally. Subsequently, the baby was successfully weaned off artificial respiratory support and discharged from the hospital after a 61-day stay. The child is now on the path to a full recovery.

 

This groundbreaking surgery exemplifies the commitment and expertise of the medical professionals at Lucknow Command Hospital in providing exceptional care to newborns with rare medical conditions. Their skillful application of innovative surgical techniques has offered hope to families facing the challenges of PRS and other complex disorders. (Edited)

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