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.

Da Nang Mission, June 2018

36 patients were assessed by the 2018 FTW team in collaboration with the Da Nang General Hospital doctors, and the week’s operating schedule was planned. The UK team was made up of representatives of the following specialities: General Surgery, Paediatric Anaesthesiology, Ophthalmic & Oculoplastic Surgery, Plastic Surgery, and Theatre Nursing. Patients were selected on the basis of the training and support levels required by the local team.

Cases included:

  • nasal reconstruction
  • craniofacial microsomia
  • extensive congenital facial naevi
  • juvenile hyaline fibromatosis
  • eyelid grafting
  • ptosis (droopy eyelid) correction
  • burn scar release

In collaboration with local surgeons, FTW operated on 12 patients over the four days. These cases included soft tissue reconstruction of facial asymmetry in craniofacial microsomia, a condition usually involving reduced volume of one side of the face including the external ear, cheek, jaws and mouth.

Extensive pigmented naevi are large pigmented areas of the skin and underlying tissues that are often in visible areas of the face and neck and have a dramatic appearance. The team of surgeons managed these cases with a combination of tissue expanders as a first stage, and, as a second stage, skin flaps to cover the areas when removed.

Juvenile hyaline fibromatosis is a rare condition in which children develop painful lumps under the skin and around the joints leading to contractures (permanent shortening). They also suffer from overgrowth of the gums. Administering a general anaesthetic in these children can be very challenging as they have short stature and limited mobility, and this case was managed by a combination of the local and visiting anaesthesiologists to successfully facilitate safe surgery.

The ophthalmic and oculoplastic team worked with the local surgeons on congenital ptosis cases, a condition where the upper eyelid does not fully open, and vision can be affected if not treated with specialist oculoplastic techniques.

Burns scar release was performed in the neck area and around the mouth and eyelids using skin grafts and skin flaps.

Reconstructions of each case were used as teaching examples, and patients from previous years were reviewed with the same teaching aims.

MRI and CT scans were provided by the hospital and sent to specialist radiologists in the UK for review and immediate reporting, so that these were discussed and also used for teaching.

The week was considered a great success by all the medics involved.

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