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Charity missions can successfully treat rare craniofacial anomalies with lack of resources

Physicians have successfully conducted charity missions in Yemen to repair facial deformities without the expertise of a specialized craniofacial team, by using simple techniques of soft tissue repair that met the community limitations and lack of facilities in the region.

H.A. Fadaak, MD, conducted 35 charity missions in different cities across Yemen from 1997 to 2001, and completed 5,100 plastic surgery procedures.

The majority of the procedures were cleft lip and/or palate and post-burn contractures.

Fadaak encountered 33 cases of rare craniofacial clefts in patients ranging in age from 9 months to 29 years. These included: syndromic craniosynostosis (Apert syndrome=3, Crouzon syndrome=2), proboscis lateralis (n=1), double upper lip deformity (n=1), holoprosencephaly (n=1), and a variety of rare Tessier clefts both isolated and mixed (n=25).

As the challenging conditions of charity missions required it, the surgeon always sought to perform the procedures in one-step.

Out of the 33 cases, he operated on 14 patients with procedures that fulfilled the following criteria of: shortest recovery, least donor site morbidity, compatible with the team’s experience and the availability of local resources.

No patient had any bony procedures performed.

If augmentation was necessary, the surgeon used conchal grafts.

All results were satisfactory to the patient, family and surgical team.

In 1997, Yemen only had three plastic surgeons, and charity missions needed to utilize the few resources available, as best as possible. Additionally in 1997, patients went to surgery in their own clothes and the annual budget for the entire hospital in Sayown city was 30,000 Yemeni Riyals ($139.44US).

In this study, the researchers offer “community-based solutions to rarely encountered problems.” – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.