An Introduction to Conjoined Twins
Kenneth E. Salyer, MD: An Introduction to Conjoined Twins
When I saw my first set of conjoined twins, I had never seen in all my career such a grotesque deformity — where two human beings 
with wonderful, very separate little souls were conjoined for a reason unknown to me. They conjure up a fascination, a feeling and an emotion in me that I cannot explain. The first time I ever saw craniopagus twins was when I was in Moscow, Russia – then the Soviet Union when my wife Luci and I were working on behalf of the World Craniofacial Foundation to establish a craniofacial center.
I had done surgery on Sasha Lichen, a Russian who worked at the National Institutes of Health, and he introduced me to Professor Canalov, who had the largest referral center for neurosurgery in Moscow and all the former Soviet Union. We arranged a meeting and I became a visiting professor – lecturing and teaching about craniofacial surgery to the cosmetologists and neurosurgeons. In a review of all of the patients, they announced, “We have two little girls joined at the head, and we cannot figure out what to do.”
I saw these girls attached at the head, and I was immediately taken by their deformity. Dr. Canalov and discussed the possibility of using tissue expanders to help them grow enough tissue to be covered when they were separated. Those doctors did go ahead and separate the girls, and they lived, but the tissue expanders ultimately failed and they had open skin grafts on the dura of the brain – without enough coverage. Eventually, Vehlia and Vidalia ended up in Dallas – where we treated them for a year and reconstructed them. After the separation, one had neurological weakness, but they have thrived. These girls had a big impact on me. They were wonderful.
We spent many months reconstructing their skulls, and we continue to hear from them almost yearly from their homes in Lithuania. What a privilege it has been to watch these girls grow into self-sufficient, young women. I keep the image in my mind of the last picture they sent me. They are both holding up their hands with the sign of the V – V for victory. This was the image that I carried with me the whole time we were contemplating the separation of the Egyptian boys. My visualization was a portrait of two healthy girls leading normal lives. That was my goal for Mohamed and Ahmed, and this is my vision for Anastasia and Tatiana. This is my intention. The impact of these children on me was and continues to be tremendous, and the idea that I would ever see one other set of conjoined twins, much less two – knowing that they are only one in 2.5 million births, never occurred to me. What an honor and a privilege.
