Neurofibromatectomy, plastic surgery
After having received 4 unsuccessful operations in Morocco and France, the multiple neurofibroma patient decided to visit renowned Bejing Puhua International Hospital in China for the 5th and final surgery.
Amine is a 16 years old teenager from Morocco. At the ago of only 2 years, a growth surrounding his right eye suddenly appeared. During the following months, this growth continued to spread to his right maxillofacial and scalp area, but as it continued to grow it did not cause any pain or discomfort. When Amine turned five years old, the mass grew into the right orbit, right face and oral cavity. Finally local Doctors diagnosed him with Neurofibromastosis Type 1, an autosomal-dominate genetic disease, characterized by multiple neurofibromas.
During the following ten years, Amine and his parents visited numerous local and even French hospitals, resulting in Amine to receive a total of 4 surgeries on his face. The last surgery was performed in May of 2011, but failed like the previous surgeries to remove the entire tumor. As a result, the remaining tumor continued to thrive and expand faster than ever before!
(As Amine grew up , the tumor continued to grow as well.)
Amine continued to grow up and as time passed by, Amine became a teenager. He now became more aware off his physical appearance and the staring look from others started to torture him. He wished so much just to look like a normal teenager, but his wish was never granted as the local hospitals couldn’t provide him with an answer to his problem. Amine’s parents continued searching for a solution and after some time the Embassy of UAE finally suggested for his parents to contact Beijing Puhua International Hospital (BPIH). Our Medical consultant was contacted in November 2017 and after pre-admission evaluation, our medical team accepted Amine for a high-challenge surgery.
Amine’s doctor in charge was Dr. Yanni Lee, who with more than 40 years of experience in this field is very experienced and knowledgeable in this field of surgery. Although very experienced, the task at hand was very difficult and two weeks priors Amine’s arrival, Dr. Yanni Li studied Amine’s case over and over again, on many occasions even till very late at night. Dr Lee analyzed the scans very carefully and looked at the position of every single nerve, muscle and blood vessel. Dr. Yanni Lee always prepares herself well before each and every surgery, but this case was indeed very difficult and very special, as she wanted to help young Amine to regain a normal appearance.
Amine was finally admitted to BPIH on Feb 24th 2018.
Upon admission, the medical team was first shocked to find that Amine’s condition was far more complicated now since the time when first made contact was made. Only four months had pasted since that time, but Amine’s condition had continued to deteriorate.
Considering the trauma Amine had already undergone with 4 surgeries and the rapid regrowth of the tumor after the surgery, Puhua’s medical team were determined to make this case a success. It was planned to remove the entire tumor, as we did not wanted young Amie to suffer even more stress and disability from further tumor regrowth. In order to make Amie’s dream a reality, the most suitable treatment protocol was only made possible if a multiple-disciplinary team was to work together and numerous consultations and meeting were carried out. The difficult tasks of tumor removal, orbital bone reconstruction, skin transplantation, muscle transplantation, and nerve transplantation were discussed in these meetings.
（Multiple-disciplinary meeting to discuss Amine’s case)
To achieve this ultimate goal, Puhua’s medical team also invited the leading plastic surgery team from Shanghai to discuss their part to this surgery in details. Finally, with all preparations in place the surgery was scheduled for April the 27th 2018.
The surgery started at 8:30 am on April 27th and was completed at 6:30 am of April 28th! A record breaking 22 hours! The surgery was a complete success with the cooperation of 20 Doctors from Puhua’s medical team and China’s leading plastic surgery team from Shanghai Hospital.
The surgery included: Identifying the facial nerve facial arteries/veins and external jugular vein and complete neurofibromatectomy (the complete removal of the tumor form Amie’s face), the intraorbital nerve fibroma resection; Reconstruction of the inferior orbital margin and partial pavimentum orbitae; parallel resection of latissimus dorsi myocutaneous flaps and myocutaneous flaps; Masseter reconstruction, and facial reconstruction.
（Photo of some of the doctor who took part in the surgery）
（Amine-right after surgery）
After observing Amie for 2 days in ICU, Amine was transferred to the patient’s room to recover. The medical team monitored his progression very closely and observed the healing of the surgical wound very carefully. We are all very glad to see him getting stronger from day to day. Amine was finally discharged on June 4th and then travelled back home to his country, where he will recover fully.
Amine’s story has drawn wide attention from Morocco and the United Arab Emirates. This unique and difficult case demonstrated the world class skills our team at Puhua can offer to it’s patients . We are very proud of our team of Doctors, their expertise and their ability to work as a team, to be able to successfully treat world class challenges.
（Before discharge, Amine and his mother took a photo with the hospital staff）