split lip and palate

My nephew was born with a split lip and a malformed palate. He is now a three-year-old boy. What is the right time for a corrective operation?

In modern practice the right time for the first operation in an otherwise healthy baby is “as soon as possible” after birth. We often operate within the second week of birth. However, you must be aware of the entire sequence of treatments your nephew would eventually need. Here’s an ideal schedule for a child’s operation. The primary lip repair should be done within weeks after birth. The palate has to be repaired nine months later and the orthodontic aspect should be taken care of soon after. If it needs a bone-graft one has to wait till the child is nine year old. Upper jaw advancement and final nose correction can be done between 16 and 18 years of age. You should also find a good speech therapist for your nephew’s treatment. Please remember that cleft lip and palate management is a planned collaborative work. Best results can only be produced by a team that will take the responsibility of the whole procedure from the first day.

gland tumour

I am 37. I have recently been diagnosed with a tumour in my parotid gland (a saliva-secreting gland just beneath the earlobe). My doctor has suggested a surgery. But he also has warned that it may lead to facial paralysis. I am scared and confused. Please help.

Please don’t get unnecessarily scared. Most parotid tumours are usually benign. The only treatment I know is: surgical removal of the gland. The possibility of facial paralysis is a real concern only if the surgery isn’t done with a lot of care. Paralysis may also occur if you wait too long, because in a few cases benign parotid tumours turn into cancerous ones later.

gutkha’s effect

I am a 46-year-old gutkha addict. I kicked the habit recently after I developed stiffness in the mouth. I can’t open it properly nowadays. Please help.

You may be suffering from a disease called oral submucus fibrosis. It is not only uncomfortable, but can eventually turn into cancer. You should see a maxillofacial surgeon and start getting initial conservative treatments with oral antioxidants and local steroid or placenta extract injections. However, the first course of action for you should be to get a biopsy done. A surgical operation may help you open the mouth (at least 70 per cent). You must remain under a long-term review by the same doctor. And give up chewing tobacco for good.

locked jaw

I am 35. I started getting problems on the joint of the jaw ever since I was a teenager. It used to click and ache. For the last few years I have been getting a ‘locked jaw’ again and again. It is extremely painful. Do you have a solution?

You have been suffering from recurrent jaw dislocation due to a weak jaw-joint. There are standard surgical techniques to correct the condition permanently. You need only a two-hour-long surgery and a two-day stay at a clinic. In two weeks you will have a normally-functioning jaw. There will be minimum pain and you’ll hardly have a discernible scar. If you went in for the surgery at the stage when you had clicks and pain, you might have avoided the surgery altogether.