Operation Smile: Doctors remove 4-pound tumor from girl’s face

In 2011, Larry O’Reilly traveled to the Caribbean nation of Haiti, to aid those who had been devastated by the massive earthquake that had occurred a year earlier.

During his stay, O’Reilly visited a small Baptist school in the mountain village of Bahon, where he handed out gifts, such as toothbrushes and soccer balls, to the young students.   But while visiting with the children, one student in particular stood out to him: a young girl with a large mass protruding from her upper jaw.

“We were going from classroom to classroom, and I noticed her and nobody else seemed to pay much attention to her,” O’Reilly, vice-chairman of the board of directors for O’Reilly Auto Parts, told FoxNews.com. “…Her face was swollen; it wasn’t too bad, but it was disfiguring.  It was already a real problem for her.”

"She would have suffocated in the next six months, as [the tumor] would have completely obstructed her air flow."

— Dr. William Magee, co-founder of Operation Smile

Curious about this young girl, O’Reilly asked the school’s pastor who she was and if she had ever received any medical care.  The girl’s name was Hennglise Dorival, and at 12 years old, she had never been to a doctor – not once.

Upon hearing this news, O’Reilly decided he would try to help Hennglise in any way that he could.  After around three months, he arranged for her to be flown to Haiti’s capital, Port-au-Prince, where she underwent an X-ray and consulted with a physician to figure out what was wrong.

There, she was diagnosed with an ameloblastoma – a rare, noncancerous tumor that often develops in the jaw near the molars.  Despite being benign, these tumors can spread very rapidly, displacing tissue and cutting off pathways to vital organs.  Left untreated, Hennglise’s tumor had expanded into her teeth, deviating her nose to the right and elevating her right eye.

Given the extent of the tumor’s spread, doctors told O’Reilly that Hennglise would need extensive surgery.

Removal and regrowth

Through an organization called the Community Coalition for Haiti, O’Reilly arranged for plastic surgeons from the U.S. to travel to Haiti to perform reconstructive surgery on Hennglise.  In a 12-hour procedure, the doctors were able to remove the facial tumor, but they informed O’Reilly there was a chance that they hadn’t captured the mass entirely.

Not thinking much of it, O’Reilly returned to the United States and didn’t travel to Haiti again for another year. When he did return in 2012, he was eager to visit that same Baptist school in Bahon – but when he arrived, he was shocked by what he found.

“We were there for a week, and the first person I wanted to see was Hennglise,” O’Reilly said. “And her face was swollen again.  I thought, ‘Oh my gosh, what’s going on?’ It looked like she had kind of been punched.  And [the pastor] said, ‘No, it’s come back.’”

Since the tumor hadn’t been completely excised during the initial surgery, it had regrown to its full size – and was only getting bigger. Determined to get rid of the ameloblastoma for good, O’Reilly realized Hennglise needed to travel to America in order to have her tumor removed completely.  In the U.S., she could have a full staff of medical personnel perform the operation, as well as adequate follow-up care to help reconstruct her face.

Yet transporting Hennglise overseas turned out to be a difficult endeavor, as she didn’t have a passport or a birth certificate. Additionally, many U.S. doctors and hospitals were nervous to perform such a risky procedure on someone who was uninsured, with many believing she wouldn’t survive the surgery. For 18 months, O’Reilly worked tirelessly to make the operation happen, running into several roadblocks along the way.

“I had to say a lot, ‘No, I’m not going to give up on this little girl,’” O’Reilly said.  “It just wasn’t in me, even though it would have been so easy so many times to say, ‘I’ve done all I can.’”

A greater sense of urgency

Meanwhile, Hennglise’s tumor continued to worsen.  The fibrous mass swelled to an enormous size, taking up the entire left side of her face, while stretching out her cheek and her upper and lower lips.  Eventually, the tumor grew so massive that it expanded into her left eye socket, pushing her eyeball outward and disrupting her vision.

Information about Operation Smile

-- Operation Smile is an international children’s medical charity that performs cleft lip and cleft palate surgery for children in low and middle income countries.

-- The organization mobilizes a network of more than 5,400 medical volunteers from more than 80 countries.

-- Since 1982, Operation Smile has provided more than 220,000 free surgical procedures for children and young adults.

-- Learn more at operationsmile.org.

“It continued to expand, and so the expansion goes into the path of least resistance,” Dr. William Magee, a leading plastic and craniofacial surgeon based in Norfolk, Virginia, told FoxNews.com. “… The bone of the floor of the eye is thin …  so [it expanded into that] and displaced her eye to be exposed.  It literally grew up to the base of the brain, so that’s when there was an urgency to take care of it.”

With even more pressure to find a doctor, O’Reilly was finally introduced to Dr. Magee through the international health organization Project H.O.P.E.  Magee is the co-founder and chief executive officer of Operation Smile, an international non-profit dedicated to providing reconstructive surgeries for children with cleft lip and palate.

Though removing a facial tumor is a much more complicated process than fixing a cleft palate, Magee agreed to conduct the surgery on then 15-year-old Hennglise at Children’s Hospital of the King’s Daughters in Norfolk.  The young girl and her mother were flown into the United States, and on April 28, 2014, Magee and his staff operated on Hennglise for 12 hours, completely removing the ameloblastoma and reconstructing her face.

“We made an incision below the left eyelid, then around the side of her nose, then through her upper lip,” Magee said.  “Like an envelope, we opened up all the tissue from around that tumor.  The tumor was attached to the upper jaw on the left … so we used a chisel to cut the bone.  We dissected it around where the eyeball should be, and essentially enucleated this four-pound-plus tumor from her face.”

Once the tumor had been removed, the surgical team used a prosthesis to construct a new eye socket for Hennglise, as they hope to help restore some of her vision in the coming weeks.  While work is still needed to fix the angle of her jaw, the surgery has completely transformed her face – and most likely saved her life.

“It’s dramatic, just comfort-wise and everything, being able to put your tongue back in the floor of your mouth – being able to breathe normally,” Magee said.  “Truthfully, she would have suffocated in the next six months, as [the tumor] would have completely obstructed her air flow.”

A new face

Once the surgery had been completed, Magee showed pictures of the results to Hennglise’s mother – who thanked the doctor with a rather aggressive embrace.

“I came into the waiting room afterward, and her mom almost tackled me,” Magee said.  “She’s kind of stone faced and doesn’t express her emotions much, but after she saw a picture of her daughter, she almost knocked me over.”

O’Reilly said he, too, was shocked after seeing Hennglise’s face for the first time, having worked for so long to make this operation a reality.

“It was emotional; I couldn’t speak,” O’Reilly said.  “Right after the surgery, you kind of saw the best, because there wasn’t any swelling… When [they] took that [tumor] out and reclosed the face, you thought, ‘Oh my gosh, that’s what this little girl can look like.’”

Hennglise and her mother will remain in the United States for another six months as Hennglise receives follow-up care and undergos minor procedures to return her face back to normal. Magee said he is confident that he removed the entire tumor during surgery and that Hennglise will never have to deal with such a condition ever again in her life.

To learn more about Operation Smile, visit operationsmile.org.

To help Hennglise and others like her, visit operationsmile.org/Haiti-Patient.