3D Technology in Maxillofacial Surgery

Life is short, and nothing makes this realisation hard to internalise like a sudden accident or death of a loved one! And this realisation turns into an acute mental stress for the survivor who gradually understands his/her limitations after an abrupt jolt that an accident can bring to his/her life. However, the evolution of modern medical science has defied such hurdles and made it possible for expert doctors to acquire specialised skills where their performances seem nothing short of miracles. In his more than a decade-long career, Dr. Sujoy Mukherjee (Consultant at Department of Maxillofacial Surgery, CK Birla Hospitals CMRI) has encountered many such trauma cases where he has successfully managed trauma injuries ranging from primary closure to complete reconstruction. Dr. Mukherjee says that in Kolkata 8 out of 10 trauma injuries occur due to road accidents (particularly bike accidents) and the rest are from sports injury, fall from a height or assault.

In 2016, Dr. Mukherjee came across a 15-year-old boy whose life took a tragic turn after a massive bike wreck. The young boy was admitted to CMRI with critical open wounds in his head and soft tissues along with severe cranio-maxillofacial and neuro injuries. At the primary stage, multiple surgeries were required to be performed to bring about a stability in his condition. He needed immediate neuro rehabilitation which continued for a long time under Dr. Rudrajit Kanjilal’s supervision (Consultant at Department of Neurosciences, CK Birla Hospitals CMRI). Dr. Sujay Mukherjee, Dr. Rudrajit Kanjilal and Dr. Anirban Bhaduri (Consultant at Department of Ophthalmology, CK Birla Hospitals CMRI), all came together in order to save this boy from life-threatening injuries.

During the first operation, the right eye had to be surgically removed as it was completely incapacitated because of extreme ocular trauma that caused his brain to stick out from that injury. An artificial eye had to be inserted in the right socket where a mesh had been used to reduce the vulnerability of exposed brain tissue. Several titanium plates and screws had to be placed on the left side of his face, while the heavily battered right side needed another set of follow up surgeries to reconstruct. The entire right side of his face was completely fractured, specifically his cheek area and the eye socket, making it more difficult to perform the reconstructive surgery at one go. The crush injury triggered multiple fractures on his nose which couldn’t be managed with a plate or a lift-up. The expert doctors embarked on doing the impossible, taking steps, each small but significant towards the young boy’s full recovery.

Commenting on the surgery Dr. Mukherjee states, “It is imperative that this boy can reclaim his life and lead it as normally as any other person. We started with contouring his face for maxillofacial surgery where our reference point was his recent photograph before the accident. Subsequently, he was under intensive neuro rehabilitation treatment. Finally, after one and a half months, he was discharged from the hospital. But our work was only half-done, as a series of reconstructive surgeries remained to be performed for his complete recovery.”

Last year, Dr. Mukherjee along with Dr. Kanjilal and Dr. Bhaduri did one more reconstructive surgery on him where his right eye which had completely shrunk in after the accident was corrected along with his cheeks. Using the latest innovation of 3D technology, patient-specific implants were produced. With the perfect imaging technique of CT scan which showed the patient’s skull, customised implants were generated and implanted on the patient.  Post-surgery, the left side of his face matches his right side, and Dr. Mukherjee plans to perform the final corrective surgery on his nose as soon as the patient crosses 18 years of age. This has rarely been done in Eastern India and it is first-of-its-kind in West Bengal where an amalgamation of pure engineering, innovations in medical sciences and highly-skilled clinicians employed the best strategies to heal a young lifeOften people talk about miracles in life when they recover from traumatic injuries, but for this young lad and his parents, miracles came in a complete package delivered by the concerned doctors who went that extra mile for the patient supported by holistic hospital care.