Wednesday, May 29, 2013

Asiatic Aesthetic Series 69:Diploma in Aesthetic Cleft Surgery



We will be launching the Diploma in Aesthetic Cleft Surgery for cleft lip and palate trainees this June for the benefit of cleft surgeons with our charity in the country. The programme will include several modules and hands on sessions over a period of 9 to 10  months.During this time ,it is hoped that the trainees would be confident enough to operate primary cases independently and understand the aesthetic concepts . The multiple choice questions after each module will help them to retain what they have been taught.
This is the first launch of our international aesthetic course in cleft lip and palate designing.Hopefully, the trainees would include expats and other countries in the very near future.
One of the main reasons why I designed this Diploma course is because nearly all the cleft surgeons in this country who traveled overseas for a year's training in the field at great personal cost, came back disappointed because they were not given the opportunity to learn cleft palate procedures hands on, and so continue to struggle and wait for a good chance for a direct one on one training in this delicate speciality. This is one very strong reason why my course was tailored to help such surgeons in poorer nations.Some have already benefited from my previous courses and are able to work independently on cleft lip.palate and other plastic surgeries. This Diploma is a continuation of what was considered a fairly successful training model over the last few years.

 The preliminary idea-

Diploma in Aesthetic Cleft Surgery
Introduction: Aesthetic cleft lip surgery includes cosmetic surgery involved in correcting a facial cleft deformity. This may be done along with, or follow, the functional reconstruction  of the cleft lip deformity where the lip muscles are repaired to enable the cleft child to have normal lip function. The concept of aesthetic palate surgery was developed in our charity after several years of palate research. This   concept involves minimal surgery with very little blood loss, muscle repositioning techniques using our own innovative techniques in order to improve speech outcomes. The technique was accepted as a paper at the  12th International Conference on Cleft Lip/Palate and Associated Craniofacial Anomalies  in May 2013 , Orlando  USA and will be published in the journal of craniofacial surgery this year in July. The same has been accepted as a paper presentation at the European Plastic Surgery Conference, Hamburg Germany, in August this year.
Aims and Objectives: To provide a  Diploma in Aesthetic Cleft Surgery  under a University Department of Dental and Maxillofacial Surgery and the charity , which is registered with the Ministry of Planning  and Ministry of Health, Yemen as an International Cleft Surgery NGO, to train Yemeni doctors and provide free surgeries for cleft patients.   During   this   period ,  each trainee will master the art of aesthetic cleft lip and palate surgery by attending lectures as well as hands on training sessions and clinical case discussions with Yemen Smile. At the end   of  the  year ,  each trainee should be able to pass the multiple choice question test with a minimum of 70% and an oral  exam from topics taught at the course. The trainees will then demonstrate their command of cleft surgery by carrying out one surgical technique of cleft lip and palate surgery under the supervision of the trainer and staff. If successful, the trainee will receive a Diploma in Aesthetic Cleft Surgery. The   number of trainees in the first year will be limited to 7 candidates only.
Programme: The training covers the aesthetic surgical aspects of the cleft deformity. This course focuses primarily on primary cleft lip and palate solutions and does not include advanced interventions  .  It is not intended to cover all aspects of cleft lip and palate management, since the goal is to enable trainees to independently operate cleft lip and palate patients on completion of the training. There is a multiple choice test after each module to help the trainees revise what they have learnt. Several topic discussions on relevant craniofacial problems,naso alveolar moulding,dento skeletal deformities and syndromes will be taught to increase the knowledge of trainees,although the course exams and questions will focus only on the prescribed syllabus.Trainees will also be helped with important articles from our library of plastic surgery materials.Local  and overseas experts will also participate in this programme for the benefit of trainees.

Hands on sessions: 
1.       Anatomical Landmarks and the C flap repair variations for  unilateral cleft lip deformities
2.       Anatomical considerations in cleft palate surgery
3.       Five  Principles of bilateral cleft lip repair
4.       Saline hydrodissection palatoplasty 2013 and variations
5.       Repair of difficult facial clefts
6.       Post op wound management, scar treatment with microneedling and PRPM
7.       Basic understanding of cleft speech/VPI

Extra resources to provide help to trainees includes the following:

1. Cleft surgery journal articles by John B Mulliken of Childrens Hospital Craniofacial Boston
2. Cleft lip/palate and craniofacial /plastic surgery journals  and articles
3. Smile Train USA biodigital smiles:https://smiletrain.biodigitalhuman.com/home/ 




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