Operation Smile: changing the world one child at a time

Saturday, 12 April 2008

Tham, a nine-year-old Vietnamese girl, was born with a rare and complicated facial deformity.

Separated in the middle by a 0/14 Tessier cleft, her face required complex surgery undertaken in multidisciplinary craniofacial centres only. For this reason, it was decided that Tham should be flown to Mater Children's Hospital, rather than undertaking this procedure at the Central Military Hospital 108 in Hanoi, Vietnam.

On arrival in Australia, Tham was seen by plastic surgeon, Dr Richard Lewandowski and neurosurgeon, Dr Martin Wood. She underwent CT scans and an SLA biomodel, provided by a leading surgical-implant company Anatomics, was made.

Tham’s surgery took place on 12 April. The seven-hour procedure saw a craniofacial surgical team join the two halves of her face together. This was achieved by reflecting her scalp, removing her frontal bone, separating her face from her skull and mobilising it.

The SLA biomodel allowed planning for the amount of tissue to be removed from the centre of her face to accommodate a join. Once this central segment was removed, the patient’s face halves, including her orbits, were rotated centrally and fixed together with wires.

The joined face was then reattached to her skull with wires. The patient then had her nose reconstructed with bone grafts from her skull and leftover nose skin flaps. The incisions were then closed, bandages and nose plaster applied.

Tham spent a night in intensive care and five additional nights in the ward before being discharged to her Australian host family. The patient’s recovery was smooth and swift, largely due to her stoic nature and determination.

Tham’s progress will be further tracked on Dr Lewandowski’s return visit to Hanoi in October this year.

Filed under: Children's
    Operation Smile patient before surgery.Mater neurosurgeon Dr Martin Wood with the Operation Smile patient before surgery.Plastic surgeon and co-founder of Operation Smile Australia Dr Richard Lewandowski with Tham

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