Monday, April 25, 2016

The Asian Pacific Craniofacial and Surgical Simulation Conference, Taipei Grand Hotel October 5-8 2008





The Asian Pacific Craniofacial and Surgical Simulation Conference, Taipei Grand Hotel
   October 5-8 2008 ( 8 scientific papers)
   Delegates: USA, Japan, Latin America , Middle East, Asia, Europe

Paper and posters:  Yemen Smile  Number: 8



Establishing an International Cleft and Aesthetic Recon Mission for a developing country in
Arabia: lessons from a 5 year experience (2003 June -2008 May)
Cleft Charity: Yemen Smile
Many patients in developing countries do not have ready access to aesthetic and
reconstructive services. The Republic of Yemen is a poor Middle Eastern country with a population of approximately 23 million people. The population is predominantly Arab with a few Jews and Africans. Health services in most parts of the country are either substandard or non existent. There are no established cleft or aesthetic recon services and many patients have to live with their deformities for the rest of their lives.
The Yemen Smile Mission Trust was formally signed in April 2007.In March 2008, with the Ministry of Planning and International Cooperation.
A locally grown International Aesthetic and Recon Mission dedicated to providing cleft care was thus formally established.

The long term goal would be to train Yemeni technicians and surgeons to carry on the mission work for the benefit of Yemeni patients.

2. Approaches to difficult post trauma nasal deformities in Yemeni Arab patients: case reports
Septo rhinoplasty and camouflage silicon implants: Lessons learnt
The post trauma deformed nose presents several challenges for the rhinoplasty surgeon because of functional and aesthetic problems .The severely injured nose often presents with bony as well as septal aberrations.The aesthetic goal is to straighten the dorsum which is often very difficult in the post trauma nose, to modify the nasal bones, to adjust the tip cartilages and iron out the irregularities in the nose.

3. Some rare craniofacial disorders in Yemen :observations under the tip of the cleft iceberg

Yemen in south Arabia till today does not have a proper record of the types or
number of cleft anomalies.In our safari smile camps across the country over a period of a few years, some rare craniofacial anomalies were encountered.
We came across eleven cases with Hemifacial microsomia, hypertelorism, traumatic clefts of the face and nose following a rare neurosensory disorder, cleft nose with intranasal dermoid, cleft with Binderoid syndrome, Aperts, Kartagener, Pierre Robin sequence, craniofacial cleft,frontonasal dysplasia and Binder syndrome with absent columella.

4. Human bite left ear: using a sliding posterior auricular perforator flap with cartilage
transfer-case report
We present a case of human bite of the left ear leading to a partial defect of the ear. The
patient was a twenty five year old lady from Djibouti who was referred to our clinic in Sana’a.
Her acquaintance had bitten off her left ear for undisclosed reasons. One could only speculate that the perpetrator who probably suffered from some sort of Para Freudian delusional disorder also had a penchant for nibbling off ladies ears. The defect was successfully repaired with a posterior auricular sliding flap based on random perforators

5. 45 minutes as the crow flies ?- revisiting the popular myth in Speedy Gonzales cleft lip
surgery

Intro: Cleft lip conditions present themselves in many different ways; no two cleft lip patients are
alike. In developing countries where the bulk of cleft patients come from, the problems are even
more complicated because of the absence of prior orthodontic treatment for most of the cases. In
fact, the smaller cleft lips seemed to take more time and expertise because of the delicate nature
of the work. The larger and wider cleft lips which require even the inferior turbinate flap plus alar
corrective surgery in some cases definitely take more than an hour at the least, even in
experienced hands. So why is it so important to say that cleft lip surgery takes as little as 45
minutes when most of us who have operated hundreds of cleft children do not seem to be able to
subscribe to this view? We undertook many cleft lip operations to see if the surgery could be done
in 45 minutes and came up with some interesting conclusions.

6. Two thumb pressure reduction of the protuberant pre maxilla in bilateral cleft lip patients i

Intro: We present a method of reducing the protuberant premaxilla in bilateral cleft
patients using pressure reduction with the thumbs. The neglected protruding premaxilla in bilateral cleft patients poses a big challenge for the primary cleft surgeon because of the difficult closure. Attempts have been made by many surgeons in the past to reduce the premaxilla but with disappointing results

7. The unilateral cleft lip-"Simple minor variations on a theme of the C flap "
Intro: The C flap repair for cleft lip deformities with it’s modifications gives some of the most accurate alignments for unilateral cleft lip defects that have been treated by prior orthodontics.In this paper,we drew a helpful analogy from Fernando Sor’s Variation on a Theme of Mozart where the guitar maestro describes several variations on the main theme in E major. The classic paper by Noordhoff remains unchanged, but there are some mild variations which one can play with when faced with unilateral cleft lip defects

8. The innovative V -2 zee triad concept flap for the neglected very wide cleft lip

Intro: The very wide neglected cleft lip presents a difficult challenge for the primary
cleft surgeon. In this case report, we present a wide cleft lip approximately 4cm wide
with a short cleft side and large nasal deformity. The traditional C flap is not suitable for
such a defect and the Millard with the usual back cut is sometimes used with an extra
baby flap below to increase the length of the lip.We present here an innovative concept
based on the musical triad .A triad is the simplest form of the chord-three notes. It can be
used in any degree of a major or minor scale. A triad consists of the 1st-root or the degree
on which it is based, the 3rd which is the major or minor above the root and
the 5th which is the perfect, diminished or augmented, above the root. In this concept
which we named the V-2 zee triad flap repair, the V is the main flap like the C flap i.e.”
the root flap” and the two zee baby flaps are the 3rd and 5th minor flaps around the triad
to give the flap the desired length. When sounded together these three flaps provide a
somewhat harmonious result. Using this concept, one is able to work around the basic
framework of the root flap and augment or diminish the smaller flaps to produce
aesthetically pleasing results in the wide cleft lip. The root C flap like the middle C in
music remains the same throughout, but with various harmonic mechanisms in technique,
one is able to make minor adjustments to achieve the most out of the surgical procedure







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