The Comprehensive Craniofacial Center: The Richardson Dental & Craniofacial Hospital

by Anup Patel, MD, MBA

Almost a year ago Jim Clune, my co-resident, and Dr. Stefano Fusi, a plastic surgeon at Yale University, participated in an Operation Smile mission to Jordan. They performed the usual run-of-the-mill cleft lip and palate surgeries typically encountered on these trips. Yet, what took them by surprise was an Indian cleft surgeon who not only performed these surgeries so elegantly, but also so rapidly, finishing almost every case in less than 25 minutes. When they came back, they told me I must make a trip to the southern tip of India and visit Dr. Sunil Richardson.

With that background, I boarded a plane from Mumbai to Trivandrum followed by a 30-minute taxi ride to Kovalam. The town of Kovalam hosts a stunning cliff that overlooks the Arabian sea, gorgeous beaches, and the popular reported to have tons of gold within its vault. What I did not anticipate was a transportation strike in the State of Kerala, where the hotel was located, circumventing me from getting to Nagercoil, located in the State of Tamil Nadu. Given my linguistic constraints of not speaking Tamil or Malayam, I found myself in a bit of a predicament. Yet, around 5 PM, a call from Dr. Richardson came and told me that he had arranged for a taxi service to fetch me from Kovalam to his hospital the next morning. You can imagine the relief that came over me as we crossed the border of Kerala into Tamil Nadu without having the car stoned by those on strike. In 90 minutes, I arrived at The Richardson Dental & Craniofacial Hospital (Fig. 1 and 2).

IMG_2122sign Figs. 1 and 2: The Richardson Dental & Craniofacial Hospital, a recognized Operation Smile Comprehensive Care Center, located in the greenery of Nagercoil in Tamil Nadu.IMG_2123building

Situated in the backdrop of mountains and lush greenery of Tamil Nadu, the four-story hospital provides comprehensive dental and craniofacial care to many of the indigent of India. It houses two operating rooms, a PACU, wards including ICU beds, clinic rooms, and a dental laboratory. Sweta, Dr. Richardson’s wife and dentist, works closely with orthodontists to ensure proper occlusion of teeth can occur in conjunction with the orthognathic movements. Furthermore, speech therapists and nutritionists work in the center and always available to offer their services.

Funding remains limited given the multitude of indigent Indians who travel kilometers across the country in hopes of receiving treatment. Dr. Richardson’s uses a great deal of his private earnings to provide care for the poor. In addition, Operation Smile supports the center given it fulfills the nonprofit’s push for comprehensive care centers such as the one in Guwahati. Cape Craniofacial Foundation donated a bus to enable a mobile outreach for patients in the state.

The clinic witnesses a gamut of craniofacial pathology from patients with poor primary cleft lip repairs requiring revisions with rhinoplasties to rare disorders such as Binder’s syndrome requiring correction of nasomaxillary hypoplasia. Most patients arrive NPO as Dr. Richardson often adds them onto this already packed OR schedule knowing they have exhausted all resources just to see him once. To this end, he sees patients in between cases and works well into the night.IMG_2121Drs

Fig. 3: Dr. Richardson and I after finishing a uvuloplasty for a cleft palate.

In the OR, he moves confidently and efficiently, facilitated by his ambidexterity as well as profound anatomical knowledge. He treats a diverse number of craniofacial problems Monday through Saturday with a daily case log comprised of the following: repair of palatal fistula , cleft rhinoplasty, LeFort I with genioplasty, ORIF of orbital floor fracture, and unilateral cleft lip. Always a student of plastic surgery, he advises to identify great mentors to bounce ideas off as well as using Plastic and Reconstructive Surgery to continue to remain innovative.

IMG_2126surgeryFig. 4: Dr. Richardson repairing a cleft lip at his the center that serves many indigent of India.

He continues to conduct research and give lectures internationally. Next week, he will travel to Palo Alto to teach in a course entitled “International Humanitarian Course” to Stanford University Medical School on cleft care in India. Furthermore, he participates in many oral and maxillofacial conferences throughout the world discussing orthognathic movements related to clefts. Continuing his academic commitment, he trains two fellows each year with a packed waiting list for those wanting to train with him.

Those of you wishing to elevate your surgical skills related to clefts and orthognathic surgery must pay Dr. Richardson a visit. Sweta and him are down-to-earh people who will take you out for authentic Tamil Nadu meals including eating off a banana peel, develop your surgical skills, and enable you to participate in changing the lives of so many indigent Indians.

Look forward to your thoughts!

 

Figures:

Figs. 1 and 2: The Richardson Dental & Craniofacial Hospital, a recognized Operation Smile Comprehensive Care Center, located in the greenery of Nagercoil in Tamil Nadu.

Fig. 3: Dr. Richardson and I after finishing a uvuloplasty for a cleft palate.

Fig. 4: Dr. Richardson repairing a cleft lip at his the center that serves many indigent of India.

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