'In need of a miracle': Surgeons perform life-changing surgery

lgierer@ledger-enquirer.comMay 13, 2014 

Alice Sammy was the object of ridicule from other children because of a medical condition that made it appear as though she had a horn coming from the front of her head.

Now, the 9-year-old girl from Liberia will have a chance at a normal life thanks to two Columbus surgeons and a host of other people who donated their skills, time and money for the cause.

Her grandmother, Rebecca Tamba, who traveled with Alice more than 5,000 miles from West Africa to Columbus for the operation, said not only was Alice's head terribly disfigured, but the child's condition caused her severe balance and vision problems. She also had seizures.

"I am so happy God made this happen," Tamba said. "We could never have had this done at home. Alice has always had a good spirit, but life has been hard for her."

In Liberia, all of the children like to wear sunglasses but because of her condition, Alice could not. She has some now.

"It doesn't seem important to us, but it is to her," Tamba said.

Alice said she is feeling well and is "very happy." She is eager to go home. Asked what she will miss here, she smiled and said Chick-fil-A.

The physicians performing the operation at Midtown Medical Center on April 22 were neurosurgeon Michael Gorum and plastic surgeon Vincent Naman.

Gorum has made trips with his family to Liberia and has hosted an exchange student from there.

A little more than a year ago, Olu Menjay, the director of Ricks Institute, a private school in Liberia, sent a photo of Alice to Gorum. It was the director of another school in Liberia, Emile Sam-Peal, who brought Alice to the attention of Menjay.

Looking at the photo, Gorum said, "We can fix that."

Encephaloceles

"It was easy to diagnose her condition as front-nasal encephalocele from the picture," Gorum said.

Encephaloceles are rare neural tube defects characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull. These defects are caused by failure of the neural tube to close completely during fetal development.

The result is a groove down the midline of the upper part of the skull, or the area between the forehead and nose, or the back of the skull. Usually encephaloceles are dramatic deformities diagnosed immediately after birth, but occasionally a small encephalocele in the nasal and forehead region can go undetected.

Encephaloceles are often accompanied by craniofacial abnormalities or other brain malformations.

"These are conceptually easy to repair although the work is tedious, and because of the limited diagnostic capabilities in Liberia, we had no idea what her underlying brain looked like," Gorum said.

Gorum said seizures and hydrocephalus or spinal fluid buildup in the brain are common conditions of the encephaloceles. That turned out to be the case with Alice. When she arrived here, the doctors were able to see a CAT scan and MRI scan that showed enlarged ventricular spaces of hydrocephalus.

The operation took around three to four hours.

Gorum said the first incision was made from ear to ear, and Alice's scalp was pulled forward to the top of her eyes. He performed a frontal craniotomy, removing all of the bone protecting the front part of the brain and its lining while Naman used a special saw to remove the bone of the brow, essentially removing the top half of the eye socket and nasal bone. This is called osteotomy.

Naman worked at a separate table remodeling the bone into a more cosmetically acceptable configuration, while Gorum dissected the lining of the brain call dura off of the skull base, exposing the actual brain where it had been chronically herniated, or protruding through the skull defect that Naman was remodeling.

Once this was exposed, Gorum amputated the abnormal part of the brain and closed the lining of the brain with a water tight seal."

Naman and Gorum then replaced the brow bone and skull. Naman removed the fleshy abnormality from the nose.

Gorum said Alice did well and left the hospital but developed high hydrocephalus. It happened because of years the encephaloceles had been functioning as a relief, and now that it was gone, the pressure built up causing problems. Gorum said Alice underwent a shunting procedure to divert spinal fluid and left the hospital May 5.

Ronald McDonald House

She and her grandmother have been staying at the Ronald McDonald House, which made special arrangements to keep them. They are expected to leave later this week.

Susan Yaksh, executive director of Ronald McDonald House Charities of West Georgia said the volunteers have loved having Tamba and Sammy as guests. "They have been super with them," Yaksh said.

Working together to bring Alice to this country were people from Effort Church in Palmyra, Va., Brookstone School and First Baptist Church of Columbus.

The girl and her grandmother didn't pay for anything.

Ryan Chandler, the president and CEO of Midtown Medical Center, came to visit Alice before and after the surgery.

"Alice's story is a testament to how people working together can create miracles for a child in need of a miracle," Chandler said. "This is a touching example how a partnership of physicians and hospital, the hospital vendors who donated their products, the Ronald McDonald House, Brookstone School and churches in Virginia and here in Columbus can make such a difference in a child's life.

"All of us at Midtown Medical Center were honored to be part of it."

Both Brookstone and First Baptist Church have connections with Liberia. First Baptist missions coordinator Kris Keske lived in the country and was principal for a year at Ricks Institute. She has taken members there for mission work, and the church has sent needed items, such as shoes.

"It is a very poor country," she said.

Cindy Sparks is director of Servant Leadership at Brookstone as well as member of First Baptist. Brookstone is a sister school to Ricks and has had exchange students there. Catherine Trotter is assistant head of the School for Advancement at Brookstone. She has been to Liberia three times.

Both Sparks and Trotter have worked as hosts for Alice and Tamba.

Sparks said persistence is the underlying theme of this story and that Gorum, who has had children attend Brookstone, was the person whose contacts "really made this happen." Sparks said that Alice showed a lot of courage coming here.

Trotter mentioned the airline was concerned about taking Alice as a passenger for fear she would have a seizure.

Paying for the flight to America was Effort Church. Tami Bourne is a member there and it was her husband, Charlie, who first noticed Alice in 2012 while doing missionary work in the country.

"Charlie said that we had to do something," Bourne said.Bourne drove here for the operation. She plans to take the two to Virginia before they return to Liberia.

Speaking about the work done for Alice, Bourne said, "This is how the body of Christ is supposed to work."

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