A second round of reconstructive surgery on the skull of a baby suffering from a rare disorder that caused her head to nearly double in size has been completed by Indian surgeons.
The four-hour-long surgery on the skull of one-year-old Roona Begum was carried out at a hospital near New Delhi where last month surgeons also drained fluid from the youngster's head in a life-saving operation.
"Today's surgery was the biggest one so far in terms of remodelling her head. I think it went pretty well," neurosurgeon Sandeep Vaishya told an AFP reporter inside the operating theatre.
Roona was born with hydrocephalus, a condition that causes cerebrospinal fluid to build up on the brain.
Her condition had caused her head to swell to a circumference of 94 centimetres (38 inches), putting pressure on her brain and making it impossible for her to sit upright or crawl.
Roona's head had shrunk to about 60 centimetres after procedures conducted in May and doctors expect it to shrink further after Thursday's operation.
During the surgery at the hospital run by the private Fortis Healthcare group, Vaishya and two other surgeons sliced through the baby's scalp in an attempt to bring her bones closer and compress her head.
Plastic surgeon Rashmi Taneja, who worked alongside Vaishya on the surgery, told AFP she had never before come across a case like Roona's.
"When we first cut open her head, all you saw were these fragments of bone floating over a fluid-filled sac. It's one of the most challenging cases I have seen," Taneja said.
Roona's right and left skull bones were some three inches (7.6 centimetres) apart, underscoring the challenges faced by the doctors, who drained fluid from the tissues inside, causing them to collapse and shrink.
The surgeons then drilled tiny holes into her bones, pulled them close and stitched them together, ensuring the tissues inside were now covered completely by bone fragments.
The success of last month's operation, which involved the insertion of a shunt mechanism that drains fluid from the baby's skull into her abdomen, has raised hopes that her head will shrink further, Vaishya said.
"My main worry is to do with the risk of infection, which we will have to watch out for. At the moment, we don't foresee the need for any further surgery," he added.
Roona lives in an Indian village with her parents who were too poor to pay for treatment.
But publication of pictures taken by an AFP photographer in the remote northeastern state of Tripura prompted the hospital to offer to treat Roona for free.
The pictures of Roona also triggered an outpouring of support worldwide with prospective donors contacting AFP and other news organisations, enquiring how they could contribute to a fund for her and her family's welfare.
Two Norwegian college students, Jonas Borchgrevink and Nathalie Krantz, started an online campaign that has raised $57,000 to help her family and fund any future aftercare.
The students previously told AFP they have already established contact with a local media website in Tripura that will help send the money to the family.
The website for donations can be viewed at www.mygoodact.com/collectiondetailperson.php?id=212.