Hanoi Craniofacial Mission, November 2019

This is the first Facing the World mission to the 108 Military Hospital in Hanoi and the first time that a team from the Hospital for Sick Children, Toronto have been involved. Mr. James Newton accompanied the team for the purpose of creating a film documentary of the mission. Mr. Anil Patel (Anaesthesia) liaised with the team at Viet-Duc hospital.

11 patients were operated on throughout the week at 108 Military Central Hospital in conjunction with members from the 108 divisions of Plastic Surgery, Anaesthesia, Neurosurgery and Ophthalmology.

Complex facial asymmetry surgery was performed to correct a significant overgrowth of one side of the patient’s mandible.  This was done in conjunction with the local orthodontists providing an excellent opportunity for teaching and training.

Teams of international medics carried out all operations.

The following conditions, were treated during the week:

  • Nasal Cleft
  • Fronto-nasal dysplasia with bilateral cleft nasal deformity and hypertelorism
  • Treacher Collins Syndrome
  • Midline nasal cleft with holoprosencephaly
  • Right unicoronal synostosis
  • Bilateral ear reconstruction

Operations undertaken by the joint team included:

Nasal Cleft: Repair nasal cleft with free temporalis fascial graft.

Fronto-nasal dysplasia with bilateral cleft nasal deformity and hypertelorism: Cleft septorhinoplasty.

Treacher Collins Syndrome: Bilateral orbital zygomatic reconstruction with right iliac crest bone graft.

Midline nasal cleft with holoprosencephaly: Nasal reconstruction with costal cartilage rib graft.

Bilateral constricted ears deformity, possible Loews Deitz syndrome: Bilateral ear reconstruction.

Treacher Collins Syndrome: Bilateral orbital zygomatic reconstruction with full-thickness right parietal calvarial bone graft, titanium mesh cranioplasty to right parietal region, fascia lata suspension bilateral lower lids with bilateral lateral canthoplasties.

Left Tessier 5, 6, 7 facial cleft: Z-plasty left cheek, reconstruction left orbital-zygomatic complex and maxilla with left iliac crest bone graft, repair cleft left upper lid, left lower lid lateral canthopexy.

Fronto-nasal dysplasia with hypertelorism status post nasal reconstruction: Sub-cranial medial orbital wall translocation with bilateral trans-nasal medial canthopexies, cleft septorhinoplasty.

Right cleft lip nasal deformity: Cleft septorhinoplasty:

Left hemi-facial microsomia: Fat harvest from both legs and 22 cc fat injection to left cheek and hemi-mandibular regions.

As part of the formal teaching program, each of the four consultants delivered lectures at Hong Ngoc Hospital, on the following topics:

  • Lecture 1:
    • Transnasal Humidified Rapid
    • Insufflation Ventilatory Exchange(THRIVE) and airway management
  • Lecture 2:
    • Anaesthetic considerations for patients undergoing Craniofacial surgery
  • Lecture 3:
    • Endoscopic versus Open Approach for Management of Single Suture Craniosynostosis
  • Lecture 4:
    • Current Concepts in the Management of Syndromic Craniosynostosis
  • Lecture 5:
    • Hypertelorism, Monobloc and Facial Bipartition: The big three
  • Lecture 6:
    • Cranioplasty in the Pediatric Patient Population
  • Lecture 7:
    • Endoscopic strip craniectomies in craniosynostosis

The support the charity received while in Vietnam by its partner hospitals, supporters and patron was incredible.

Capacity exists for the development and creation of a high-volume program dedicated to help care for infants and young adults with complex craniofacial conditions.

A repeat mission in the next 12 months is suggested as well as continued fellowships at the Hospital for Sick Children in Toronto are planned for 2020.

Hanoi Mission October 2019

The third targeted Mission has been a great success. A team of three consultants from the UK, representing maxillofacial and oculoplastic surgery, assessed a total of 71 patients.

Treatment plans were put in place in collaboration with the Vietnamese surgeons. 15 patients were operated on throughout the week, at Hong Ngoc Hospital and Viet-Duc University Hospital.

This mission focused on the delivery and teaching of complex orbital and facial bone surgery for patients with severe congenital facial deformities, and on post-trauma reconstruction. In addition to this, further progress was made regarding the planning and provision of jaw realignment (orthognathic surgery) building on the work of the previous two maxillofacial missions.

In conjunction with the Vietnamese team, five orbital reconstructions were performed, including the preparation of sockets for eye prostheses, unblockage of tear drainage systems and management of a young child with acute orbital trauma (white-eye blow out fracture).

A complex facial asymmetry surgery was performed to correct a significant overgrowth of one side of the patient’s mandible. This was done in conjunction with the local orthodontists, providing an excellent opportunity for teaching and training.

In addition, other operations were undertaken: removal of a large osteoma (bone tumor) within the frontal sinus, post traumatic nasal surgery, and post cancer resection nasal tip revision, as well as lower eyelid reconstruction and a mid face lift.

The mission’s purpose was to undertake cases which required multidisciplinary input to plan and treat complex orbital and orthognathic cases.

Teams of UK consultants and Vietnamese consultants carried out all operations.

The following conditions, were treated during the week:

  • Facial clefting
  • Hemi-mandibular hypertrophy
  • Tear drainage problems
  • Traumatic injuries to the eye and face
  • Neurofibromatosis
  • Sinus pathology

As part of the formal teaching program, each of the three FTW consultants delivered a 2 hour lecture at Hong Ngoc Hospital, on the following topics:

  • Lecture 1: Applications of Patient Specific Planning in Maxillofacial Surgery by Mr Mehmet Manisali at Hong Ngoc Hospital
  • Lecture 2: Orbital fracture repair complications and Lacrimal injuries and repair by Ms Sarah Osborne at Hong Ngoc Hospital
  • Lecture 3: Augmentation techniques in Facial Surgery by Mr Jahrad Haq

We are hugely appreciative of the support the charity received while in Vietnam from its partner hospitals, supporters and patron.

Facing The World to support children with facial differences in Vietnam

Ms Le Ngoc Chi VGPC CEO and Ms Katrin Kendel FTW CEO signing the MOU

The Vietnam Grand Prix Corporation (VGPC), Promoter of the Formula 1 VinFast Vietnam Grand Prix 2020, is honoured to announce its partnership with leading international charity, Facing the World (FTW), in supporting children with facial differences in Vietnam.

The Memorandum of Understanding (MOU) will see both parties work together to help support FTW’s medical experts to implement volunteer programs in Vietnam and also to facilitate the international educational exchange programme for doctors from Hanoi’s three main Craniofacial Centres with world leading institutions in the UK, USA and Canada. VGPC will also use its platform to help increase awareness of the plight of the many children in need of life changing surgical intervention in Vietnam so that FTW can raise the necessary funds to cover the operating costs for children who require these complex surgeries. The MOU was signed at the UK Ambassador’s Residence and in the presence of representatives from the UK, Canadian and US embassies, related government organizations and FTW’s partners Vietnam Airlines and the Hong Ngoc Corporation.

Read more here.

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