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After more than 20 years of pain and silence, 22-year-old Priyanka Chhetri from Assam can finally smile and enjoy her mother's cooking. A facial injury in childhood left her with a locked jaw and facial deformity so severe that she had to survive on a liquid diet. But thanks to the efforts of doctors at the Government Dental College in Ahmedabad, she has been given a second chance at life—completely free.
A rare opportunity for the poor
For the majority of patients like Priyanka, such complex surgeries are almost out of bounds. Most government hospitals lack the specialists and expensive facilities required for such complex procedures. Her condition, Temporomandibular Joint (TMJ) Ankylosis, requires advanced surgical skills and equipment worth more than Rs 3 lakh.
Even Ayushman Bharat, India's flagship health insurance program, provides minimal coverage for such reconstructive surgeries — it covers just Rs 15,000 for one surgery and Rs 30,000 for a pair of limbs. Desperate to regain her life, Priyanka traveled a five-day bus and train journey to Ahmedabad, her only hope for a normal life.
How doctors make such surgeries possible.
The success of these life-changing surgeries at the dental college has been achievable because of donor funds and aggressive fundraising on the part of the medical team. "We rely on donors to provide surgical instruments and equipment, which allows us to perform these expensive procedures," said Dr. Sonal Anchalia, Head of Oral and Maxillofacial Surgery. She first met Priyanka at a medical conference in Guwahati and invited her to Ahmedabad for treatment. Since then, the hospital has been a source of hope, treating about two patients from across India each month.
Such surgeries are usually done at big public hospitals. But at the dental college, we can do so as donors help us a lot with surgical instruments and apparatus, since no government hospital in Assam does such surgeries, I asked her to come to us. Now we get almost two patients every month from across India.
Dr. Sonal Anchalia, Head of Oral and Maxillofacial Surgery
A nationwide reach: Patients from across India
In the last year, 14 jaw reconstruction surgeries have been carried out by the college, and another nine are planned for the next year. Patients come from Uttar Pradesh, Madhya Pradesh, Rajasthan, and Gujarat, with more female patients compared to males.
Priyanka's condition was caused by trauma during childhood, but TMJ Ankylosis can also be caused by infection, rheumatoid arthritis, or congenital factors.
We deal with several kinds of malformed jaws or jaw joint fractures that need replacement. Some of these children have not just had distorted faces but have had difficulty breathing due to constriction of the windpipe, slurred speech, and difficulty eating or swallowing.
Dr. Sonal Anchalia, Head of Oral and Maxillofacial Surgery
More Than Just Cosmetics: A Life-Saving Surgery
Priyanka's condition led to an asymmetrical growth of the jaw, which severely compromised her airway and caused obstructive sleep apnea (OSA). Dr. Anchalia and his team performed a complex procedure that separated segments of bone and rebuilt her jaw with the assistance of a device.
"We use elastic bands in the mouth to direct the growth of the bone. The most irregular bone structure can be corrected using this method. Her teeth had also grown in a very haphazard manner due to the stunted growth of her face. So we had to correct that as well" she said.
Government hospitals are not interested in performing such surgeries due to the lengthy process and the stages involved.
Planning takes about 25 days. Then we conduct the first surgery to implant the device in the jaw. A week later, we begin turning the screws to lengthen the lower jaw and allow the soft tissue to fill up. At 1 mm per day, we go up to 25-30 mm in total. This can take about 1.5 months of stay in the ward.
Dr. Sonal Anchalia, Head of Oral and Maxillofacial Surgery.
A new start for Priyanka
Now that her wounds have healed and her jaw has been reconstructed, Priyanka finally has the confidence to go out without fear or shame.
"My family never ate in front of me so that wouldn’t feel left out. I can look at myself in the mirror without negativity and am finally excited about my future" she said.
As the eldest of three siblings, Priyanka is keen to get to work and earn for her family. She will attempt to find employment in Guwahati prior to returning to Ahmedabad for the next phase of her treatment. "The soft bone takes six to eight months to grow and consolidate. After this, we will do a mouth and chin surgery. We will replace the jaw joint with a 3D-printed titanium prosthetic which will be fitted there to mimic the natural joint" said Dr. Anchalia.
(Input from various sources)
(Rehash/Muhammad Faisal/MSM)
