
“Without intervention, the erosion of the metal plate could have reached his brain,” says Dr. Adam S. Jacobson.
Credit: NYU Langone Staff
A 17-year-old from Mongolia is back home and thriving after undergoing a complex, lifesaving reconstructive surgery at NYU Langone Health, thanks to a yearlong effort between NYU Langone surgeons and a nonprofit organization focused on global health outreach.
Byamba-Orgil Erdene-Amgalan had lived with a devastating jaw injury for more than two years following surgery in Mongolia to remove a noncancerous tumor. Surgeons there reconstructed his jaw using a metal plate, but as Byamba grew, the rigid hardware did not. Over time, it began to erode into the base of his skull, threatening to breach the protective barrier around his brain. He was also unable to open his mouth more than a centimeter, making it nearly impossible to eat or speak.
“He was facing a very dangerous situation,” said Adam S. Jacobson, MD, director of the in the at NYU Langone. “Without intervention, the erosion of the metal plate could have reached his brain, resulting in a fatal complication.”
NYU Langone surgeons describe the use of virtual planning and 3-D printing techniques to reconstruct Byamba’s jaw.
Dr. Jacobson met Byamba during a surgical mission to Mongolia last year with the . It was one of several trips he’s made with the organization, which coordinates global surgical outreach and training. Dr. Jacobson, along with a team of NYU Langone surgeons, residents, nurses, and fellows, operated on about 15 patients during the weeklong trip, but they were unable to treat Byamba on-site due to equipment limitations. Dr. Jacobson knew the teen’s urgent case was solvable with the right resources.
Back in New York, Dr. Jacobson began working with leaders at NYU Langone and the Virtue Foundation to arrange for Byamba to travel to the United States, where the NYU Langone multidisciplinary team could perform a fibular free flap reconstruction—a complex procedure that uses bone from a patient’s leg to rebuild the jaw.
In an extraordinary turn of events, a group of Mongolian head and neck surgeons who were already scheduled to train at NYU Langone through the Virtue Foundation were able to observe the surgery. Together with NYU Langone plastic and reconstructive surgery specialists Jamie P. Levine, MD, chief of microsurgery in the , and David A. Staffenberg, MD, vice chair of pediatric plastic surgery, the team used 3D-printed surgical guides to plan and execute the intricate procedure.
The operation was a success.
“After the procedure, Byamba quickly began to show remarkable progress,” said Dr. Levine. “His speech and chewing function are back to normal, and he returns home able to smile and eat normally again. It was incredibly meaningful to help give him a second chance.”
Byamba spent several weeks recovering in New York with support from the Virtue Foundation.
“A year ago, I was hoping the American doctors would come back to operate on me,” Byamba said through a translator. “I never could have dreamed of coming to the United States for this procedure, but I always wanted to see New York. The doctors made me feel safe and secure, and now I am more confident about my future. I feel like I can do anything.”
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NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone No. 1 out of 115 comprehensive academic medical centers across the nation for three years in a row, and U.S. News & World Report recently placed nine of its clinical specialties among the top five in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 7 inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.
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