When America Alcantara of Austin quit ducking behind her mother and burying her face in her pudgy hands, she gleefully snapped photographs of the adults she had met an hour earlier in a medical office and spun in every empty chair on Monday.
The energetic 7-year-old will slow down for the summer after undergoing a surgery today that is expected to last 12 hours. Afterward, America will wear a halo-type frame around her head for two or three months and must be careful not to bump it. Twice each day, her mother, also named America Alcantara, will have to tighten screws around the halo to help the bones in her skull move into the correct position.
The surgery is a delicate, complicated procedure to open up and enlarge the girl’s too-small skull, a symptom of Crouzon syndrome, a rare, inherited disorder in which the bones of the skull became fused early in life, resulting in bulging eyes, breathing problems and a short, broad head. She already is losing sight in her right eye and wears a hearing aid, said Dr. Patrick Kelley, chief of the department of craniofacial, plastic and reconstructive surgery at Dell Children’s Medical Center.
During the surgery, Kelley and neurosurgeon Tim George will push her brain aside, break bones in her skull and insert metal plates to make more room. They will insert a splint behind the upper part of her mouth.
It is thought to be the first surgery of its kind on a child in Austin. It will save the Alcantaras many trips to Houston, where they had planned to go for the surgery before it was canceled four times in the past two years for various reasons. When new doctors arrived at Dell Children’s and read about America in the American-Statesman’s Season for Caring charity campaign last year, they said they could do the surgery here.
After about 10 days in the hospital, America will be seen initially by doctors twice a week to make sure she is healing properly, Kelley said. One surgery probably won’t solve all her problems. She’ll need another operation when she’s about 14 to further correct her bite, said Dr. Adriana Da Silveira, a craniofacial orthodontist who designed the mouthpiece.
Today’s surgery is risky. Possible complications include infection, damage to the brain and death, Kelley said. “It takes exquisite attention to detail at every step,” he said.
The surgeons will give top priority to protecting the brain and approach the reconstruction “like a sculpture,” George said. The surgery is not cosmetic, but improving the facial structure will make America look more normal.
America, who finished the first grade at Cook Elementary School in North Austin on Tuesday, is popular at her school, but at first, the children had a lot of questions, said Alcantara, 32. She teared up describing how hard it was to place her daughter in after-school programs because America is not accepted easily by those who don’t know her.
“It’s the children who reject her,” Alcantara said. “Some children run away crying.”
Classmates hugged America as she left school. Her mother hopes that, soon, she will begin to look more like them.
“I think she will do well,” George said.
Copyright 2008 The Austin American-Statesman. All rights reserved.