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Docs operate Iraqi child's huge facial vascular malformation

Baby Raimas
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Baby Raimas Alzahayawat with her father after surgery

Rohit Shishodia
Doctors at Mumbai’s Global Hospital have given a new lease of life to a one-year-old Iraqi baby, who was living with a complex facial defect, by successfully performing a high risk surgery on her.

The baby, Raimas Alzahayawat, was diagnosed with large vascular malformation over the left side of the face which resulted in swelling due the excessive or abnormal development of blood vessels.

The complex surgery was performed with precision without causing any facial deformities. After the surgery, the baby is doing well and has healed.

In Iraq, the baby’s mother noticed the swelling over the left side of her face. The family panicked and ran from pillar to post to get appropriate treatment.

At 6 months of age, the baby underwent injection treatment (sclerotherapy) at a local hospital. However, there was not much relief. After this, the skin over the swelling became fragile and the child had 2-3 episodes of severe bleeding from the lesion.

The baby would continuously cry and refuse to eat food. With no treatment available locally, the baby was referred to Global Hospital, Parel, in July 2019.

Dr Nilesh Satbhai, Consultant Plastic and Reconstructive Microsurgeon, said, “The child was diagnosed and treated in a systematic manner. After thorough clinical assessment, we performed a CT scan with angiography and also a DSA (digital substraction angiography).”

Dr Satbhai added that this helped in detailed analysis of the vascular malformation and also the extent of the lesion. It was understood that there was a large vascular malformation over the left side of the face (involving the left cheek, angle of mouth, part of upper and lower lip, extending up to the nose and orbital margin).

Vascular malformations are a complex problem formed by a developmental defect which causes the blood vessels in a particular body part to develop abnormally or excessively.

This results in a mass or swelling which is full of multiple blood vessels. They can be of different types (hemangiomas, capillary malformations, arterio-venous malformations – slow/high flow), and vary in size from time to time because of swelling and blood flow within the malformation.

Dr Sathbhai said, “Preoperative embolization was carried out to block the abnormal and enlarged blood vessels and reduce the blood flow to the lesion as this helps in reducing the risk of excessive blood loss during the surgery. Complete excision of vascular malformations is challenging but with the help of flap cover to reconstruct the large skin and soft tissue defect over the face, the lesion was successfully resected, with minimal blood loss.”


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