Mumbai: City hospital gives Iraqi toddler her face back

Raimas Alzahayawat with her father after the surgery

When baby Raimas Alzahayawat was a month-old, the left side of her face started swelling with blood oozing out of it. By the time she was six-month-old, the left side was completely swollen due to abnormal growth of nerves. She stopped eating owing to her facial deformity. The Iraqi national recently got a new lease of time after undergoing a complicated plastic surgery at a city-based hospital after being an year old.

Ever since the baby's face began swelling, the family has been running from pillar to post to find an appropriate solution. At the age of six months, she underwent injection treatment (sclerotherapy) at a local hospital. But this made the skin over the swelling become fragile with two-three episodes of severe bleeding from the lesion. With no treatment available locally, the baby was referred to Global Hospital, Parel in July. A surgery of removal (excision) of the vascular malformation and reconstruction of the large soft tissue defect over the face was performed here.

Dr Nilesh Satbhai, consultant plastic and reconstructive microsurgeon, said, "After thorough clinical assessment, we performed a CT scan with angiography. This helped in getting a detailed analysis of the vascular malformation and also the extent of the lesion. It was understood that there is a large vascular malformation over the left side of the face (involving the left cheek, angle of mouth, part of upper and lower lip, extending up to the nose and orbital margin)."

Vascular malformations are formed by a developmental defect which causes the blood vessels in a particular body part to develop abnormally or excessively. This results in a mass or swelling full of multiple blood vessels. They can be of different types, and vary in size from time to time because of swelling and blood flow within the malformation.

'My child is more playful now'

Raimas would cry most of the time and refuse to eat. Montasir Alzahayawat, her mother, said, "We were shocked when we noticed the abnormal swelling over the left side of her face which made it impossible for her to open her mouth. We were extremely afraid after the episodes of severe bleeding from the lesion. We were not able to find any suitable doctors or hospitals in Iraq to deal with this problem. My child is now cured though. We are especially happy with the cosmetic result. She has started accepting feeds and is more playful now."

How it was done

Preoperative embolization was carried out to block the abnormal and enlarged blood vessels and reduce the blood flow to the lesion as it prevents excessive blood loss during the surgery. Complete excision of vascular malformations is challenging but with the help of flap cover to reconstruct the large skin and soft tissue defect over the face, the lesion was successfully resected with minimal blood loss.

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