Posted on December 30, 2018

Sidra Medicine has successfully operated on a four year old patient, born with congenital facial palsy. The child, Ozair could not move the left side of his face because of the underdevelopment of his facial nerve at birth. This also meant that simple functions like smiling or being able to communicate clearly were difficult.

Ozair underwent two operations, led by Dr. Graeme Glass, Attending Plastic and Craniofacial Surgeon at Sidra Medicine. The first was to rebalance the muscles of his lower lip, and the second, a more complex surgery, was to take a muscle from his thigh to recreate a smile.

Commenting on the case, Dr. Graeme Glass said, “Conveying feelings by way of facial expression is crucial to good communication and positive, meaningful social interactions. For children with facial palsy, trying to smile can come across as a grimace instead. This can result in the child being misunderstood and socially isolated. Ozair came to us when he was three and a half years old, and a multidisciplinary team involving a number of specialists have helped devise a management plan to give him his smile back.”

Ozair’s second operation took approximately six and a half hours. It required removing muscle from his inner thigh and transferring the muscle to his face. The blood vessels were re-attached under a microscope.  A new nerve supply was borrowed from the muscle used to clench the teeth and was connected to the transferred muscle.  Using a portable ultrasound machine to “listen” to the reconnected blood supply, Ozair’s new smile muscle was monitored closely in the first 48 hours.  He was discharged after four days. His post-operative recovery took three weeks. 

“The surgery was one of the most challenging operations for plastic surgeons. The nerve supply will take at least three months to grow into the nerve of the new muscle to make it move. I am confident that with the help of our therapists, Ozair will learn to smile symmetrically and spontaneously over the next 12-18 months.  The presence of a spontaneous smile will be a huge step towards him rediscovering his confidence and being able to express himself more clearly,” continued Dr. Glass.

Ozair’s parents said, “It is truly beautiful to see our lovely little boy Ozair being able to smile. Dr. Glass, Dr. Stotland and the wider team at Sidra Medicine have all played a key role in transforming not only his smile but also his life. We are already starting to see subtle changes to his personality since the operation and appreciate the post-operative follow up and care we continue to receive. We are very grateful to the Government of Qatar and Qatar Foundation for their commitment to providing highly specialized medical facilities for children in the country. To have a hospital like Sidra Medicine in Qatar has made all the difference knowing that we didn’t have to consider traveling abroad to seek the type of world-class care Ozair received here.”

The Plastic and Craniofacial Surgery program at Sidra Medicine leverages the expertise of a distinguished team in providing cutting edge care to individuals with congenital and acquired deformities of the skull, face and hand. It provides a comprehensive range of services for children and young people with isolated and syndromic craniofacial conditions – including total cranial vault remodeling, distraction and spring expansion; the full range of cleft lip and cleft palate surgeries, orthognathic surgery, orbital and eyelid reconstruction, ear reconstruction; facial re-animation surgery; primary and secondary facial trauma reconstruction; as well as the treatment of complex hand anomalies and vascular anomalies.

Dr. Mitchell Stotland, Division Chief of Plastic and Craniofacial Surgery said, “Ozair’s care and treatment, is just one of many examples of the cutting-edge surgeries that Sidra Medicine offers in Qatar. It highlights the comprehensive and collaborative nature of our clinics, as Ozair was initially referred to me on account of his congenital missing ear (a condition referred to as microtia). As we have world-class expertise in different areas of Plastic and Craniofacial Surgery, Ozair was transferred to Dr. Graeme who specializes in facial reanimation. Following the recreation of Ozair’s smile, in a few years, I will work on manufacturing a new ear for him from his rib cartilage.”

A multidisciplinary team including physiotherapy, neurology and child psychology will continue to play a key role in Ozair’s follow up care at Sidra Medicine. “Not only have we started to see interest from cases internationally, we are also witnessing reverse medical tourism in some cases, where many families who would have travelled abroad for specialist plastic and craniofacial surgery for their child are now opting to come to us instead. The quality of care, the patient and family centered approach, the high-tech facility and services and most importantly the diverse and highly specialized teams that we have at Sidra Medicine, can rival most of the top children’s hospitals in the world,” Dr. Stotland concluded.

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