First time in Canada: Surgeons at The Montreal Children’s Hospital and McGill University successfully remove a tumour from a baby’s face..… through his scalp!
The child was discharged about an hour after surgery. He has recovered rapidly and fully since.
“We were extremely surprised to learn the tumour was covered by bone,” says Dr. Fanous. “Despite this hurdle, the surgery went extremely well. This type of surgery requires a relatively simple technique, but the surgeon has to be careful because the face contains a dense ‘forest’ of nerves, muscles and vessels. The surgeon has to ‘navigate’ around all of these elements to get from point A to point B. If the surgeon inadvertently damages one of the important nerves or muscles, he risks permanently affecting or even paralyzing the child’s upper face.”
HOW IT ALL BEGAN
Dr. Sherif Emil was the first surgeon to examine Jayden in late 2008. He determined the toddler had a congenital tumour, possibly of the type called ‘dermoid cyst’. While this type of tumour is benign, it has to be removed because it may grow as the child ages and could rupture, causing serious infection and scarring. Traditionally, these types of tumours are removed by simply cutting through the skin and muscle directly over the tumour. However, this technique leaves a scar, one that Dr. Emil wanted to avoid at all costs since it would be in the centre of Jayden’s forehead. Also, the scar would have gotten larger as Jayden got older, especially since the little boy has dark skin. People with dark skin are known to have much higher risk of scarring. Thanks to the use of this new endoscopic technique, Jayden will be spared an unsightly scar. Instead, he has a tiny scar hidden by his hair.
“I had read about the endoscopic excision of benign forehead masses in the Journal of Pediatric Surgery. Pediatric surgeons at Stanford University had used the technique,” says Dr. Emil. “I knew right away Jayden was a perfect candidate for this procedure. I wanted to do everything possible to prevent the child from having a scar in the middle of his forehead.”
Because this technique had never been used in Canada to remove a facial mass, Dr. Emil began to search for a surgeon with enough experience to attempt it. He finally reached Dr. Fanous, a renowned facial plastic surgeon. While Dr. Fanous had never performed this surgery on a child, he had done it hundreds of times on adults during facelift surgery. He readily agreed to perform the surgery and to provide the necessary equipment to The Montreal Children’s Hospital.
It took eight months from the first time Jayden was seen by Dr. Emil until the day of his surgery. During the surgery, the anesthesia team headed by Dr. Pierre Fiset, Director of Pediatric Anesthesia, secured the child’s safety. A number of surgeons and surgical trainees filled the operating room in order to witness this ground-breaking procedure. The nursing staff prepared tirelessly for the operation, assuring a calm and safe environment for the patient.
“We had complete confidence in both Drs. Emil and Fanous,” says Ron Cambridge, Jayden’s dad. “We also appreciate the fact that Dr. Emil went to all of the trouble to make sure my son wouldn’t have to live with an ugly scar on his face. I really feel he went the extra distance and, for this, my wife and I are very grateful.”
“Jayden is an example of the unique care that can be provided by the Montreal Children’s Hospital and McGill University,” says Dr. Emil. “Medical and surgical experts from diverse disciplines can collaborate to provide the best care for life.”
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Manager Public Relations and Communications
The Montreal Children’s Hospital of the MUHC
You can download photos and videos of the surgery including before and after photos of Jayden at: http://www.thechildren.com/en/medias.aspx