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.
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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.
![Photo 1](https://facingtheworld.net/wp-content/uploads/2020/01/Photo-1-1.png)
Teams of international medics carried out all operations.
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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
![9](https://facingtheworld.net/wp-content/uploads/2020/01/9-scaled.jpg)
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.
![Photo 2](https://facingtheworld.net/wp-content/uploads/2020/01/Photo-2.png)
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.
![Photo 3](https://facingtheworld.net/wp-content/uploads/2020/01/Photo-3.png)
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.
![Photo 4](https://facingtheworld.net/wp-content/uploads/2020/01/Photo-4.png)
![Photo 5](https://facingtheworld.net/wp-content/uploads/2020/01/Photo-5.png)
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
![20](https://facingtheworld.net/wp-content/uploads/2020/01/20.jpg)
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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