Ground-breaking surgery corrects a condition called arhinia

Posted on 7 March 2014

Imagine not being able to smell freshly baked bread, or your neighbour’s newly cut lawn. This is what Ennica Mahkge has been missing out on for the last 19 years. She has congenital total arrhinia, which means she was born without a nose.

Ennica suffered many complications apart from being unable to smell. She was also forced to breathe through her mouth, which was dangerous while eating, as that puts her at risk of choking. When she was born, an ostium (a procedure that involves making an opening in the windpipe) was created to help her breathe, but this meant she was susceptible to upper respiratory tract infections.

‘Facial disfigurement has a devastating impact on the way the person interacts with others and how society reacts to him or her,’ says Dr Cules van den Heever of the Department of Prosthodontics at the University of Pretoria. ‘In addition to social exclusion, these patients may experience other problems that result from the loss of facial tissue, for example difficulties with chewing and swallowing food, breathing and speech impairment.’

‘There are only about 50 reported cases in the world,’ says Dr van den Heever. ‘The procedure was definitely the first in South Africa.’

And so history was made at Mediclinic Kloof when a team of specialists, including Dr Van den Heever, Dr Hermann Kluge (maxillofacial and oral surgeon) and Dr Johan Kluge (ear, nose and throat specialist), gave Ennica a new nose. The surgical team created a nasal cavity, facial implants, tear ducts and, once these areas had healed, a prosthetic nose.

In a recent update, Dr van den Heever told us that Ennica’s progress has been excellent. At first, the flow through her nose affected her speech and she was referred to a speech therapist, but she adapted to her new face within two weeks without therapy. She was motivated and determined, he says – the best kind of patient. Her nasal prosthesis, which is made of silicone and retained in place by a special magnet, is removed twice a day for cleaning. Apart from this procedure, her nose is like anyone else’s… and her breathing is, for the first time in her life, normal!

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