She will receive a titanium plate in the coming days, to cover an opening in her skull, and an inner ear implant.
A gunman shot the teenage activist in the head and neck in October as she rode home from school in Pakistan's Swat Valley.
Islamist extremists from Tehrik-e-Taliban intended to kill her for taking a stand for the right of girls to get an education. The terrorists have said they will target her again.
The 15-year-old's brain
swelled dangerously days after the shooting, so doctors in Pakistan
extracted a section of her skull about the size of a hand. Otherwise,
the pressure in her cranium would have caused severe brain damage,
likely killing her.
"There is no doubt that
the surgery performed in Pakistan was life-saving," Dr. Dave Rosser,
medical director of the Queen Elizabeth Hospital in Birmingham, UK, said
Wednesday at a news conference.
Malala has made impressive strides and
faced her medical treatment with bravery, Rosser said.
"She's very lively.
She's got a great sense of humor," he said. She is aware of her high
profile in the world and what that could mean for her safety.
"She remains incredibly cheerful, incredibly determined and incredibly determined to speak for her cause," Rosser said.With the patch of skull
missing, Malala is limited in what she can do. Her brain is vulnerable
to injury, if she bumps her head in the wrong way. Only her skin and
soft cranial tissues stand between the outside world and her brain, and
that's not enough.
Doctors could have
covered the breach with the original piece of her skull, which she has
carried under her skin since October, where a surgeon in Pakistan
implanted it for safe keeping.
That's a common procedure to preserve bone fragments for later use, Rosser said.
But her own skull
section would have no longer fit properly without the addition of some
titanium parts, as her head and the bone fragment have changed.
Titanium also has a low incidence of infection and can be handcrafted to near perfection, doctors told her.
"It was Malala's final decision," Rosser said. She picked the titanium plate.
She will also receive a
cochlear implant to restore hearing to her left ear, in which she is
currently deaf. The gunfire broke the delicate bones that help turn
sound into sensory impulses to the brain.
The device will not
allow her to hear completely naturally but will restore enough function
to the damaged ear to allow her to hear in three dimensions, which is
important for safety. It will allow her, for example, to hear an
approaching car, Rosser said.
Malala also recently had
surgery to reroute a facial nerve that was damaged in the attempt on
her life, leaving part the left side of her mouth listless.
"There is a very good chance after this procedure that within a year to 18 months, this will completely recover," Rosser said.
She will then hopefully regain her old smile.
To make the titanium
plate, prosthesis maker Stefan Edmondson had the section of Malala's
skull with the gap in it reproduced by an object printer.
Then he patched the hole
with wax and carved it to fit the shape of her head, Edmondson said,
and he used the wax section to give the titanium its form.
As for the skull fragment she has carried inside her since that emergency surgery in Pakistan:
"The bone will be removed from under the skin in her stomach and cleaned up and sterilized and given to Malala," Rosser said.
She wants to keep it as a remembrance.
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