Yousafzai will have a titanium plate attached to a large hole in her head.

Malala Yousafzai's operation: construction of a new skull

Birmingham, UK, January 30, 2013-15-year-old Pakistani schoolgirl Malala Yousafzai (Malala Yousafzai) survived the Taliban attack and became an icon of the global resistance movement, she will soon undergo surgery To repair her broken skull and damaged hearing.

In the next 10 days, Yousafzai will undergo a three-hour surgery to fix a titanium plate on a large hole in her head and implant a cochlear hearing aid to replace her damaged eardrum. She will announce today that she will undergo surgery Hospital.

These operations will be performed by the same surgeon who treated the British soldiers injured in Afghanistan and will put the teenager on the road to recovery, which will enable her to start her work as a global advocate for girls’ education and start relatively normal in Birmingham, England. life.

"We very much hope that if you see her in two years, there is no sign that she has experienced everything she has experienced," said Dr. Dave Rosser, the medical director of Queen Elizabeth Hospital. Birmingham told ABC News in an interview today. "This allows her to start again."

Last October, Yusufzai was shot 3 times. One of the bullets hit her left forehead and passed through the skin along her head. According to the Queen Elizabeth Hospital in Birmingham, the bullet itself did not damage her skull, but its shock wave shattered the thinnest bones in her skull and damaged the soft tissues of her chin and the bottom of her neck. She has been recuperating there. Rest there. Accept her surgery.

Doctors in Pakistan saved her life by removing one of her skulls, reducing the pressure on her brain when it was swelled by the shock wave. The large hole left by the doctor-about a third of one side of her head-will now be covered by a procedure called titanium cranioplasty.

“It not only reshapes the skull, but also protects the brain,” said Dr. Stefan Edmondson, the maxillofacial prosthetist who created the titanium plate. "There is no reason it shouldn't stay there for the rest of her life."

The hospital said in a statement emailed to the media that her doctor will shave her head and fold back the flap covering the hole to expose the dura mater, the fibrous membrane that covers her brain. Then a 0.6 mm thick steel plate was fixed to her skull, and the screws were put into the 2 mm deep holes drilled in her head. Then the flap is covered on the board and sutured in place.

Her doctor in Pakistan stored the skull in her abdomen, hoping it would survive and reinsert it into her skull. But Malala, her family and the hospital believe that titanium is a better choice than trying to reinsert the bone that may carry the infection.

"The bones have been under her skin for a while," Rosser said. "And some of the calcium will be reabsorbed. So it will be slightly smaller than before, of course it will be thinner and less strong than before."

Edmundson said that the titanium plate "imitated the bone that was taken."

"We started with a flat piece of titanium, and then we started pressing it in a two-part mold," he explained, fixing the plate in a place that looked like a punch. "This was completed in a week or two. In a sense, we must constantly re-examine it, reduce it slightly, and modify it."

In the second process, a small cochlear device will be implanted to let her left ear hear the sound again. The hospital said the bullet damaged her skull and also destroyed her eardrums and all the bones she needed to hear.

"Knowing who is talking to you in a crowded room is good for society. When you cross the road, knowing where the car is coming from is also an obvious safety benefit," Rosser said.

Yousafzai underwent emergency surgeries while in Pakistan. Compared with those, her doctors in Birmingham said these surgeries were less traumatic. They predicted that they only lasted three hours, and she will become an outpatient in a week or two. Nine people will undergo surgery, including two neurosurgeons and a burn and plastic consultant surgeon.

Personally, they are relatively conventional. The hospital performs 50 procedures per year. But Rother admits that it is extremely rare for the hospital to perform both operations at the same time—especially for people who have suffered so much trauma like Yousafzai.

"Of course, doing both of these tasks on a person who has already undergone facial nerve reconstruction, and I think the other things she does are very unique," Rosser said.

He revealed for the first time today that Yousafzai has undergone surgery in Birmingham to repair her damaged facial nerve. Rother told ABC News that her face was no longer symmetrical and she could not shut up properly. After the operation, her face has at least an 80% chance of healing completely in the next 9-18 months.

But Russer said that Yusufzai showed no signs of long-term injury, was able to speak and read, and was expected to fully recover.

"She will inevitably have some difficult times," he told ABC News. "But as I said, she is very, very strong. I have no doubt that she will overcome any challenges."

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