Physicians in the Palestinian Authority knew that a complex facial reconstruction was the only hope for a young resident with a complex facial tumor. The procedure is not available in the Palestinian Authority. Following appropriate arrangements, the patient was transferred to Rambam Health Care Campus (Rambam) in Haifa, Israel, where an expert surgical team implemented an innovative life-changing solution.
Photo:L to R: Dr. Omri Emodi, Professor Adi Rachmiel, Dr. Salach Nseir, Dr. Nidiel Zeineh, and Dr. Amir Bilader – members of the surgical team.Photo: Rambam HCC
Aisha*, a resident of the Palestinian Authority, suffered from an exceptionally large tumor and facial disfigurement. The complexity of her case required expertise not available in her local hospital. Fortunately, her physicians knew where to find that expertise and arrangements were made to send her to Israel for treatment – at Rambam.
An expert multidisciplinary surgical team met to discuss the complexities of Aisha’s condition. While this kind of surgery is performed at large medical centers worldwide, Aisha’s condition presented unique challenges. The team would have to remove a cancerous growth and reconstruct the cavity caused by the tumor. In addition, normal jaw function needed to be restored so that the young woman’s quality of life would be as it was before the tumor developed.
According to Dr. Yotam Shkedy, director of the Head and Neck Surgery Unit, Rambam specialists are highly qualified in performing surgeries of this kind. This procedure, however, presented extraordinary challenges due to the vast damage to her face. “We had to come up with a unique solution that could be fully implemented in one procedure.”
The team developed and performed a two-stage procedure. During the first stage, bone was transplanted from Aisha’s tibia to repair her jaw bone, facilitated by advanced 3D imaging technology. During the second stage, tissue would be transplanted from her thigh and used to repair the external damage on her face.
The surgical procedure lasted nearly ten hours, though at one point, time was of the essence. “We were essentially working against the clock,” Dr. Salech Nseir, an attending physician in the Department of Oral and Maxillofacial Surgery explains. “Tissue and blood cells have a two-hour life outside of their natural environment. We had only this short window of opportunity to correctly and effectively connect them.”
The complex procedure involved a large multidisciplinary team of anesthesiologists, nurses, and surgeons. Among the surgeons were also the director and deputy director of the Department of Oral & Maxillofacial Surgery, Professor Adi Rachmiel and Dr. Omri Emodi, respectively; Drs. Nidiel Zeineh and Amir Bilder, residents in the Department of Oral and Maxillofacial Surgery; and Dr. Roni Barzilai, a resident in the Department of Ear, Nose & Throat, Head & Neck Surgery.
Dr. Yotam Shkedy shares that the surgical team was pleased with the results. “There is no doubt that the successful outcome of a case like this is made possible by the dedication and collaboration of highly-skilled multi-disciplinary medical professionals, all focused on the best medical outcome. Aisha is recuperating and we are very optimistic regarding her recovery.”
* Name changed to protect the patient’s identity