Abu Dhabi, September 08: A 14-year-old boy, Ahmed Ibrahim Muhammad underwent a rare jaw reconstruction surgery, as a part of a procedure requiring the removal of a tumour on his chin. Ahmed, a Sudanese, suffers from a rare genetic disorder which makes him prone to tumorous growths, particularly skin cancer.
Ahmed underwent the complex 15-hour maxillofacial surgery six months ago at Shaikh Khalifa Medical City (SKMC). It involved a radical re-sectioning of his chin, jawbone and floor of the mouth and reconstruction of the jaw with a bone (fibula) from the leg and reconstruction of his chin (“fibular free flap”) with skin taken from his thigh.
“I believe this was one of the most complex maxillofacial surgery in the UAE, integrating different functional components such as the mouth, chin, jaw, as well as different tissue types including, skin, muscles, bony structures, arteries, veins and nerves,” said Dr Robert Lorenz, surgery consultant at SKMC and chief medical officer at Cleveland Clinic in the US.
“Free-flap reconstruction surgeries have been performed successfully at SKMC in the past. However, the bone free-flap such as in this case is a more complicated procedure. There is no place in this region that could take his leg bone (between knee and ankle) and make a new jaw for him, it is new for SKMC,” Dr Lorenz stated.
According to Dr Lorenz, Ahmed suffers from a rare genetic disorder called Xeroderma Pigmentosum that makes him prone to form curable but potentially lethal skin cancers.
“He’s sensitive to the sun and is prone to developing tumours. He’s at risk of skin cancer a hundred times more than the average person. Usually, people with this condition have skin cancer before they’re 20 years old,” described Dr Lorenz of Ahmed’s condition.
“Xeroderma Pigmentosum is extremely rare and affects one in 200,000 people,” said Dr Lorenz, adding that two of Ahmed’s family members also suffer from the same genetic disorder.
Although the cancers that Ahmed suffers from are curable if caught early, he has not had access to proper medical care. His father, Ibrahim Muhammed Ibrahim, a government employee at Liwa, initially tried to get him treatment in Sudan, their home country, when they learnt of a small tumour on his son’s lower lip.
For four years, both father and son searched the hospitals in the UAE but were told that due to the complexity of the case, late stage presentation and lack of experts, proper treatment for his condition was not available and only palliative option existed at the stage.
Lauding his patient, Dr Lorenz said Ahmed was “tremendously brave and courageous throughout the operation”. “He has been cured after almost three months of hospital stay and close medical observation, although there was no guarantee that the surgery was going to be ultimately successful given its extreme advanced nature,” he said.
In fact, Ahmed developed an infection after the operation, which was attributed to lack of nutrients and not complications. “He was very malnourished when he was admitted. He was not able to eat much because it was very difficult for him. The nutrients in his body were very low,” said Dr Lorenz, adding that for a massive reconstruction such as this, there is always a 15 per cent risk of infection.
Asked about his ordeal, Ahmed shyly but cheerfully replied that he can now eat properly. He thanked his doctors for the treatment and the hospital staff who contributed money to buy him a portable playstation which he plays regularly. Now, Ahmed will next undergo a surgery which will include creating a small lower lip and lower teeth for him and make the scars smaller.
Although the tumour has been removed, Dr Lorenz cautioned that he is still at risk of developing cancer elsewhere in his body. “He’s prone to form tumours, but as long as he picks them up when they are small, there’ll be no problem,” he said.
But for now, the class VII student is just more than happy to be able to still play football.
He said he dreams of becoming an engineer some day and building a house. But for the meantime, he’ll focus on studies and brush up on his Arabic and reading, his favourite activities.
–Agencies