Guyana’s first skull replacement surgery was successfully completed on August 22 at the St. Joseph Mercy Hospital (SJMH) by neurosurgeon, Dr. Amarnauth Dukhi.
The patient, 24-year-old Analisa Latchman—a single parent and mother of one—is fully on the road to recovery and is expected to be discharged on August 27.
Dr. Dukhi recalled that Analisa was seeking relief from intense headaches.
“It was really painful to see a young lady with a small child suffering so much,” he said.
After a thorough medical investigation, he diagnosed her with a rare genetic bone disease—Craniofacial Fibrous Dysplasia—that afflicts one to five persons out of every 15,000 to 30,000 people.
The doctor said he had never diagnosed this rare disorder before and it was the first time he had encountered someone suffering from it. He noted that symptoms include excruciating headaches that and can seriously affect an afflicted person’s daily activities. He added that the disorder could have severely disrupted the functions of Analisa’s brain if it had been allowed to progress.
In Analisa’s case, her left eye had begun to recede noticeably, Dr. Dukhi explained, and her symptoms fit into the classical progression of the disease, which causes distortion of the face as normal bone is replaced with fibrous soft tissue. The doctor decided to take up the challenge to assist Analisa free of cost, provided she could raise the money for the hospital facilities and the required implant.
SJMH Board Member, Christopher ‘Chris’ Fernandes A.A. was contacted for help. Recognising that the young lady needed urgent and possibly life-saving surgery that had never been done in Guyana, he worked diligently to coordinate negotiations and finalise arrangements for her to get access to the hospital’s facilities at a reduced rate.
Analisa’s relative, Dr. Sarah Lall-Khan gave a moving background to her plight. She said Analisa had suffered a long time from exceptionally painful headaches, but several doctors she consulted were unable to diagnose the cause of her symptoms. Dr. Lall-Khan said she suggested that Analisa needed the assistance of a neurosurgeon, which led to her consultation with Dr. Dukhi.
“All we were doing was treating the pain, but we hadn’t found the cause of the pain and had no diagnosis to work with,” she said. Dr. Lall-Khan noted that Dr. Dukhi was able to diagnose the disorder immediately when he saw a CT scan that Anna Lisa took for him to review.
According to Dr. Dukhi, the intense pain Analisa was feeling was caused by the hard tissue of her skull pressing against the soft tissue of her brain. Noting the asymmetrical appearance of her face, he determined that she would require surgery to remove 40 percent of her skull that had become fibrous and was pulling her cranial structure into the brain. An implant would then have to be inserted and perfectly aligned to the curvature of her facial structure.
Dr. Dukhi’s clinic, Neurospine Services Inc. contacted partner company Vision Medical Ltd. in Trinidad which played a role in the arrangements for the implant which was then developed by KLS Martin (another partner company) in the USA, utilizing a 3D image generated in Guyana. The implant was a perfect replica of the portion of skull that had to be removed from Analisa. It was airlifted to Guyana and arrived on August 20.
With the help of a largely female medical team, and assistant surgeon Dr. Anna Singh, Dr. Dukhi performed the delicate operation, bypassing critical nerves in a six-hour surgery. He described the surgery as uneventful and successful.
There were no complications and he foresees none for Analisa who can now go on to live a full and normal life. Analisa was able to walk and eat shortly after surgery and she seemed cheerful as she recuperated this week at the St. Joseph Mercy Hospital.
Deputy Chief Executive Officer at St. Joseph Mercy Hospital, Mrs. Deborrah Ramsay said the institution’s administration is pleased with the partnership they have developed with Dr. Dukhi and his clinic, Neurospine Services Inc. She said the administration looks forward to more surgeries of its kind, including the possibility of Open Awake Surgery for the brain.
“We are moving into an area of service coming from Dr. Dukhi in this hospital in a very a 21st century way… I am so happy people don’t have to travel anymore to do this type of surgery that would cost them five times the amount that it would cost in Guyana. We are very pleased with the partnership.”