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.


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