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Titanium cranioplasty "happy part" of Malala's recovery, expert says

Birmingham Queen Elizabeth hospital announced today that Malala Yousufzai, the young Pakistani activist who was shot in the head by the Taliban, will be undergoing a titanium cranioplasty within the next 10 days.

If all goes well, this could likely be the last surgery that the 15-year-old will need for her injury. Yousufzai will also receive a cochlear implant in a small hole in her skull which will help restore hearing to her left ear.


"This is all good news," Dr. Anders Cohen, chief of neurosurgery and spine surgery at The Brooklyn Hospital Center in New York who was not involved in Yousufzai's case, told "This is the happy part. She's out of the woods clinically, and this is the reconstructive phase."

Previously, Yousufzai had a part of her skull removed and implanted in her abdomen to allow her brain to swell and keep the bone viable for transplant. However, her doctors and family opted for a titanium plate because it had a lower risk of infection.

For the procedure doctors will fit a titanium plate over the missing area of Malala's skull, which currently is only covered by skin and a fibrous membrane called dura. Her doctors said at a press conference the plate is engraved with a small arrow pointing in the direction where it should be fitted, to guide surgeons.

Cohen said that because Malala is young and has likely reached her final height, she's less likely to have future complications from the procedure.

"Now that it's all calmed down, they'll be putting a prosthetic piece of bone (the titanium plate) in," Cohen added, saying the "cosmetic" procedure will smooth out the surface of the skull so a person won't be able to see where it was removed.

Yousufzai was shot once in the head and once in the neck on Oct. 9, 2012 when she was riding the bus home from school. The Taliban claimed responsibility for the attack, saying that she was targeted because she spoke out against the Taliban and idealized "the biggest enemy of Islam" Barack Obama.

"This was a new chapter of obscenity, and we have to finish this chapter," said Taliban spokesman Ahsanullah Ahsan said in initial interview with the Associated Press. "We have carried out this attack."

The young girl had become an activist in Pakistan, frequently advocating for the right for girls in her country to get an education. She wrote a column for the BBC's Urdu service about what is was like to live under the Taliban regime when she was 11 years old, and has won a peace prize for her work.

Dr. Dave Rosser, medical director at Birmingham Queen Elizabeth hospital in Birmingham, England, said that Yousufzai's recovery is thanks to the immediate life-saving treatment she received in Pakistan right after the attack as well as the continued treatment she received in the British hospital.

"Had the first operation not been at a high standard, she wouldn't have survived," said Rosser.


Pakistani military surgeons removed the bullet that pierced through her head and ended up in her upper chest soon after the attack, CBS News reported. She was just transferred to the U.K. in order to get "integrated" care at Birmingham Queen Elizabeth, which specializes in care for children who have had serious injuries.

Since then, the Birmingham Queen Elizabeth said she made a dramatic recovery. Yousufzai was able to walk out of the hospital on her own in early January. The family said it plans to return to Pakistan once she has fully recovered.

"I'm hoping this will be the final step," Cohen said. "If everything goes well and she heals well, this will definitely be the last step she'll need for this injury."

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