Bengaluru: Thirty-one-year-old Sonal Sharma did not pay much attention to a mild swelling on her face, assuming it was a mosquito bite. She ignored the initial irritation and subsequent discomfort.
Little did Sonal know that she was suffering from Fibrous dysplasia, an uncommon bone disorder. "She had already visited a few doctors and consulted me after her swelling became persistent and painful. She also met her family doctor who prescribed antibiotics for the same," said Dr Aditi Bhatt, Consultant, Surgical Oncology, Fortis Hospitals, who asked her to get a biopsy done. "Initially we thought it was a giant cell tumour and it was definitely a worry," she added.
Explaining further, she said, "Sonal was diagnosed with a tumour of the upper jawbone (maxilla). The removal of the tumour became necessary., Considering Sonal’s age, we did not want to make an external incision, as that would leave a scar permanently from the eyes to the lips. Moreover she had a history of scars not healing well and was very concerned about it."
"Conventional surgery involves an external incision and leads to dissimilarity between the two sides of the face. Some form of reconstruction would have also been required after the surgery," said Dr Athira Ramakrishnan, Consultant, ENT, at Fortis Hospitals, along with Dr Aditi.
Making a a decision, the doctors decided to go ahead with the “partial maxillectomy through a facial degloving” approach. The degloving, as the name suggests, is similar to removing a glove. The outer section of the skin is pulled from the underlying tissue, severing the blood supply.
"In this procedure, there was no incision made externally on the face and the tumour was approached internally through the gums to avoid any marks on the face. The tumour was removed completely, preserving as much of the normal bone as possible. Tissue from the mouth was used to reconstruct the face to provide symmetry," says Dr Athira.
On pathological examination, the tumour turned out to be a rare kind, occurring due to some developmental defect and is unlikely to recur. "Less than one per cent of all brain tumour cases are in the upper jawbone," says Dr Aditi, adding that it took three-and-a-half-hours to complete the operation. Post-operation, Sonal remained at the hospital for a few days, after which she was discharged.
"It was a very difficult phase in my life. But the doctors at Fortis Hospital instilled confidence in me and I’m really glad that there is no scar on my face. The surgery was successful and I’m back at work and so is my husband," sums up Sonal Sharma.
