* Sidra Medicine performs surgery on baby girl with Apert syndrome
Sidra Medicine has introduced many cutting-edge surgical techniques to Qatar, including the treatment of children affected by conditions such as Apert syndrome.
A joint collaboration between the Plastic and Craniofacial Surgery and Neurosurgery Divisions, has conducted operations in which large portions of the skull bone have been cut, re-configured and sometimes “stretched” into new shapes and positions. Many of these complex transformations require several surgical stages over a number of years to account for changes related to ongoing growth of the child.
Apert syndrome is a rare craniofacial condition, occurring in approximately 1/65,000 live births worldwide. Apert syndrome includes characteristic malformations of the patient’s skull, face, hands, and feet, as well as variable deformities in other anatomic areas.
Children with Apert syndrome require the expertise of neurosurgeons during surgery, who play a major role in removing parts of the skull safely while protecting the child’s brain and minimising blood loss. This allows craniofacial surgeons to remodel the child’s head safely.
Dr Mitch Stotland, the division chief of Plastic and Craniofacial Surgery at Sidra Medicine said, “We are one of the few paediatric hospitals in the Middle East to offer truly ground-breaking surgical interventions for rare and complex syndromes. While the majority of the plastic surgery performed at Sidra Medicine for cleft lip/palate, microtia, facial palsy, craniofacial microsomia, hand deformities, facial trauma, etc is undertaken independently, all cranial reconstructions are performed in a specialised centre with expert paediatric neurosurgery collaboration.”
Dr Khalid al-Kharazi, senior attending physician, paediatric neurosurgeon at Sidra Medicine said, “The neurosurgery aspect when it comes to treating children with Apert syndrome is to allow space for their brains to grow. Our role is to prevent problems developing problems like pressure inside the head. Also, the risk of leaving a skull that is prematurely fused, can result in brain damage. This can also restrict developmental progress and may lead to blindness.”
A successful treatment case for Aper syndrome at Sidra Medicine is that of Baby Eva who was born with all the typical findings related of the issue including the characteristic cranial and facial deformities, as well as webbed fingers and toes.
Dr Stotland said, “As part of her Apert syndrome, Eva’s skull was restricted in growing forwards and backwards, resulting in a so-called “tower skull” deformity and eyes that appear to bulge forward due to the eye sockets being very shallow. In addition, we know that babies like Eva have an increased risk of elevated pressure on the brain, as well as difficulty closing their eyes properly both while they sleep and sometimes even when they are awake.”
After consultation at Sidra Medicine, the neurosurgery and craniofacial team’s recommendation was to surgically provide Eva’s brain more space to grow, and to advance the eye sockets to allow better protection for her eyes.
Eva’s first surgery was performed in November 2020. Her surgery involved the use of an implantable expansion device. Once installed, it will gradually push the back of her skull out over a period of weeks.
Eva recovered very quickly from her surgery and was able to return to her normal behaviour in a matter of days. Eva will return to Sidra Medicine in a few months for the next stage of her treatment and reconstruction which will involve the removal of the expansion device springs and a surgical advancement of the bones of her forehead and upper eye sockets. This will be followed by another surgery to separate her webbed fingers.