CAIRO: For the first time, a reconstructive surgery was performed on a patient with two fully developed mouths. The patient is fifteen-month-old Rokaya Mohamed, an Egyptian girl who was flown to Los Angeles to receive a surgery that had never before been attempted. The surgery was performed last Wednesday, and was paid for in part by nonprofit organizations including Mending Kids International, the Children of War and Operation Smile. Initially, the young girl's family was told that she could not live. Rokaya proved resilient however, and continued to grow and become healthier. “The X-rays, the ultrasound didn't show us how her face is going to be,” Rokaya's father, Tamer Mohamed, told ABC affiliate, KABC-TV, through an interpreter. “We are going to fight to change her life.” The doctor in charge of the surgery was Dr. William Magee III, the Medical Director of International Programs in the Department of Plastic and Reconstructive Surgery at the Los Angeles Children's Hospital. Magee and his team have performed over 100 facial cleft surgeries on children from over 50 different countries globally. His father, Dr. William Magee Jr, established Operation Smile in 1982. When Magee III heard of her condition, he decided to offer the surgery to the family. “We spent a lot of time planning the surgery, but we made some final decisions on how to go about it while in the operating room,” said Magee III. “The face is made of multiple pieces, so it's like pieces of a puzzle. The cool thing is that we were able to use all those extra pieces in Rokaya's face.” Magee III believes that Egyptian doctors will be able to cater to the young girl's medical needs, though Rokaya will need to undergo many more surgeries in her life. “We're very well-experienced in terms of bringing in children around the world for these surgeries,” said Magee III. “We thought we could do an excellent job and get her home safely. She's done quite well, better than we anticipated.” Rokaya was released from the Intensive Care Unit on Monday, and will most likely remain in the United States for a few more weeks to recover from the surgery. While Rokaya's condition is unprecedented, over 200,000 children worldwide are born with a cleft lip or palate. According to Magee Jr, statistically every three minutes a child with a cleft is born, and many of them are “born in developing countries to parents facing extreme poverty.” As is the case, the parents cannot afford surgery for their child. The children that survive are often shunned by society, and have difficulty eating and speaking due to the cleft. “Many children born with clefts don't survive,” continued Magee Jr. “After surgery, a child can live their life with dignity. They can grow, speak and become productive members of their communities. And they can finally share their smile with the world.” Research into the cause of facial clefts has been thus far inconclusive, yet there are many factors currently believed to have an influence in the creation of a cleft palate within the first trimester. Among the typical environmental factors such as pollution and tobacco, there are also 10 genes that are proven to have some degree of influence. Magee III believes prenatal care is instrumental to avoiding clefts. “Folic acid has jumped out as something that is extremely important here, along with getting the right water,” said Magee. Of course, developing nations have an enormous hurdle to cross when it comes to such specialized treatment. According to Magee III, their biggest obstacle is the ability, or rather lack thereof, to provide access to such treatments for their children. “Rokaya's story represents an extreme example of this kind of dilemma,” said Magee III. “We are currently trying to set up training so that hospitals around the world are capable of surgeries for their own children, and they don't have to travel all the way here to get the surgeries they need.” BM
