Haitian boy comes to UAB for jaw surgery

After his broken jaw joints sealed shut, Alix Guillaume's mouth was locked closed for two years. Surgery enabled him to eat, talk and smile again.

We eat. We talk. We laugh. Most of us work our jaws throughout the day without a notion of the complicated orchestration of muscles, joints and tendons required to work a complex joint. We smile and take for granted the ability to do so.

Alix Guillaume, a 15-year-old Haitian boy, knows all too well what happens when the orchestration of facial movements stops.

More than two years ago, Alix fell out of a tree while playing. This accident caused bilateral intracapsular condylar fractures. His injuries would go untreated as the 2010 Haiti earthquake hit soon afterward and medical care was directed to the severely injured. As time passed and his wounds healed, his jaws sealed shut.

“Alix’s injuries resulted in a rare jaw deformity known as bilateral temporomandibular joint ankylosis,” explains Shaunda Kelly, M.D., an assistant professor of oral and maxillofacial surgery at UAB.

Alix dropped most of his weight, surrendered much of his self-esteem, quit school and lost hope for the future.

But months after his plunge caused his jaws to freeze together, he met a group of doctors from the University of Alabama at Birmingham Department of Oral & Maxillofacial Surgery and things changed for the better.

“We visited Northwest Haiti Christian Mission Hospital in Port-au-Paix for a weeklong mission trip in October 2010 to help in the disaster recovery,” recalls Kelly. “Alix and his family traveled eight hours to be seen by our doctors, and we wanted to help him.”

Kelly says the unfortunate truth was that performing the necessary surgery to correct his jaws would have been too risky in Haiti.

“Alix couldn’t open his mouth at all,” remembers Patrick Louis, M.D., professor in the UAB School of Dentistry. “We knew it was not an easy problem to fix, and it was an anesthetic problem as much as it was a surgical one; Alix needed to come to the United States to have his jaws repaired.”

But it wouldn’t be easy or quick. After more than a year of working with the U.S. Embassy in Haiti, getting letters of support and securing funding for the trip from the Rotary Club of Birmingham, Alix and his older sister Marie Chantell travelled to Birmingham at the end of February 2012.

Once in Birmingham, first on the docket was getting CAT scans of Alix’s jaws to give the doctors a clearer picture of his condition.

“His scans showed us that the typical ball and socket found in a jaw joint were no longer there,” says Louis. “Alix had just one massive segment of bone underneath his skull base.”

Alix underwent surgery at Children’s of Alabama for bilateral TMJ reconstruction with rib grafts on March 5. The surgical team of Louis, Kelly and Peter Waite, M.D., D.D.S., chair of the UAB Department of Oral & Maxillofacial Surgery, had to remove the excessive bone to create space for Alix’s jaws to move again.

“We had to release some of the muscles of his jaw that had shortened, so he could move them. Then, because he is still growing, we used rib grafts to reconstruct his jaw joints to allow for catch-up growth,” says Louis.

More than a week after his surgery, Alix was able to open his jaw for the first time in more than two years.

During his recuperation from surgery, Alix and his sister called the Ronald McDonald House of Alabama home. April Dickerson, manager of guest relations, says though Alix and Marie Chantell speak Creole, she knew he was recovering very well.

“At first he was a little embarrassed and would smile, but then he’s like, ‘Hey, I’m doing things I wasn’t doing a few years ago.’ He definitely has a bigger, happier smile, and the teenager is coming out. We love it,” Dickerson says.

Waite’s wife, Sallie, and other volunteers kept Alix and his sister entertained. They went to a UAB basketball game, the zoo and other popular sites in Birmingham.

Alix’s doctors say he is recovering well from surgery, and within in a few months he should be completely healed. On April 10, Alix and his sister flew home to Haiti, with devices in tow to exercise his jaw. He’ll receive further follow-up care at home.

“With continued physical therapy, Alix will soon be able to completely open his mouth and hopefully have a normal remainder of his childhood,” says Louis.

Not only have these doctors opened Alix’s jaw and put a big smile back on his face, they’ve unlocked his world. His time spent with his physicians has inspired him; he wants to return to school and one day fulfill his new dream of becoming a doctor.

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