August 26, 2010

Jaw surgery gives Chinese girl reason to smile wide

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Kevin Kelly, M.D., D.D.S., examines Lankui Wei after surgery to repair her fused jaw. (photo by Anne Rayner)

Jaw surgery gives Chinese girl reason to smile wide

Lankui Wei has just the kind of smile you'd expect from an adolescent — one that's often accompanied by that quizzical eyebrow curl typical of pre-teens.

But until recently, the 11-year-old's smiles didn't come so easy. Her jaw was frozen shut — teeth painfully clenched for six long years after an accident in her village in China.

“This is the most severe case I have seen in a long time,” said Kevin Kelly, M.D., D.D.S., director of the Vanderbilt Craniofacial Surgery Center and Pediatric Plastic Surgery. “She must have been in pain when it happened. If she stopped moving her jaw at that time, the rapid healing that occurs in children who have broken a bone would have quickly sealed the joint.”

In April, Kelly operated to give Lankui a functional jaw once again. It was a gift made possible by the Monroe Carell Jr. Children's Hospital at Vanderbilt, which agreed to cover all of her medical expenses, and missionaries from the Chinese Agape Foundation, who found her at an orphanage in the Nongli of Guli village deep in rural China, and arranged to get her here for the surgery.

“I had the opportunity to meet her one day on a medical mission,” said Faith Borck, a 19-year-old Nashville native and Agape volunteer whose family is now hosting Lankui. “She is a hard worker with a great attitude.”

Lankui comes from a family of four girls. Her mother left when she was small, and her disabled father died two years ago.

She is the first in her family to be educated up to the third grade level.
She helps take care of her nieces and nephews at home, and is the first partially literate member of her family. But the stoic nature that comes naturally to the slight pre-teen might be the reason her injury progressed as far as it did.

A 3-D imaging scan of her skull taken before surgery revealed that the bones in the joints of the mandible at the base of her skull were crushed, which then healed abnormally.

Lankui Wei, right, came to VUMC from China for surgery on her injured jaw. Here she laughs with her interpreter, Faith Borck. (photo by Anne Rayner)

Lankui Wei, right, came to VUMC from China for surgery on her injured jaw. Here she laughs with her interpreter, Faith Borck. (photo by Anne Rayner)

No hint of a jaw joint remained on the left side. There was a solid stretch of bone seamlessly sealing her jaw to the base of her skull.

“She says a door fell on her when she was 5 and crushed her head between it and some stone steps. The doctors in that part of rural China didn't know what to do to help her. Her jaw froze that day and has been frozen since,” Borck explains.

Borck calls herself Lankui's host-sister, but because she speaks Mandarin she also serves as the girl's interpreter. Lankui seems to do pretty well despite the language barrier, and since the surgery she has been using her new jaw-power to talk, as well as eat up a storm.

“She was so skinny when she arrived. She has grown an inch and a half and she's been eating like crazy since she got her jaws opened. Her favorite thing is a big chicken sandwich meal from Hardees,” Borck said.

Kelly succeeded in using available bone and tissues to reform a workable jaw for Lankui. Four molars had to be removed because they were badly decayed, but Kelly said the results are gratifying so far. She can function well and has been able to eat a regular diet. Now it is up to Lankui. To keep her jaw from sealing once again she must aggressively work to retain her functional bite.

“At physical therapy they stretch her mouth and measure. Sometimes she challenges them to open her jaws wider. She'll say “Measure again!” she wants it wider, and is willing to work for it,” said Borck.