|Year : 2020 | Volume
| Issue : 2 | Page : 157-158
Organizing craniofacial surgery teams
Arun K Singh
Vice Chancellor, Atal Bihari Vajpayee Medical University; Department of Plastic Surgery, K. G. Medical University, Lucknow, Uttar Pradesh, India
|Date of Submission||21-Nov-2020|
|Date of Acceptance||26-Nov-2020|
|Date of Web Publication||16-Dec-2020|
Dr. Arun K Singh
Vice Chancellor, Atal Bihari Vajpayee Medical University; Department of Plastic Surgery, K. G. Medical University, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh AK. Organizing craniofacial surgery teams. Natl J Maxillofac Surg 2020;11:157-8
The mere mention of Craniofacial Surgery to most of the plastic and maxillofacial surgeons brings a sense of aloofness. They are hesitant to take this up as a career option. The reasons are obvious. For our specialty, mortality is rare. However, in Craniofacial Surgery, mortality is a reality. Good anesthesia and intensive care unit (ICU) care facilities are mandatory. Treatment is time taking over a period of years and surgeries often multiple. Insurance companies do not cover these surgeries. It is further compounded by the inability of the patient to pay.
My own story is similar. As a postgraduate resident, we would just skip over the chapter of Craniofacial Surgery. This surgery was not done in our country, nor any examiner would ask about it. I felt the same that is not possible in our circumstances and hence it is of no use to us.
This impression changed, when in 1987, Dr. I. T. Jackson visited our department and just with a micromotor demonstrated fronto-orbital advancement.
It downed on us that Craniofacial Surgery is feasible, doable in our setup with the instrumentation available here. Subsequently, I started doing Craniofacial Surgery. A team from the World Craniofacial Foundation (Dr. Kenneth Salyer, Eric Arnaud, and Dr. A. Gosain) visited India, and identified three centers, where craniofacial work could be promoted and these centers become nidus for development of Craniofacial Surgery in India [Figure 1].
|Figure 1: Dr. Kenneth Salyer, Dr. Eric Arnaud, and Dr. Arun Gosain visiting Plastic Surgery Department, K G Medical University, Lucknow, in 2008|
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A lot of water has flowed through since then. There has been quality improvement in available facilities toward safe anesthesia, blood transfusion, monitoring gadgets, specialized pediatric ICU, etc., The surgery is safer now. Many individual surgeons have started doing Craniofacial Surgery, along with their neurosurgical colleagues, notably in Lucknow, Delhi, Chandigarh, Mumbai, Chennai, Bengaluru, Hyderabad, Kochi, Jaipur, etc., to name a few., Yet, surgeons are few. The situation in neighboring countries is still dismal. I have had the privilege of introducing Craniofacial Surgery in Pakistan, Bangladesh, and Nepal. However, it is yet to take off in the right earnest.
Most of these centers are surgeon based and not center oriented. The whole spectrum of Craniofacial Surgery is being done in our country, though sporadically. The way ahead is to have regional centers, where regular craniofacial work is done providing volume. It will bring quality and will act as centers of teaching and training. Concentrated efforts should be made to initially have at least one such center in each state. The treatment may be funded/subsidized by the government, charity groups/nongovernmental organizations. An effort was made in 2012 to form a “Craniofacial Foundation” to have efforts directed toward this aim [Figure 2]. Charities have to be involved to help these patients overcome financial constraints.
|Figure 2: Formation of the Indian Craniofacial Foundation at Lucknow in 2012|
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| References|| |
Jackson IT, Dublener R, Chandra R, Chabra DK, Singh AK, Kumar P. Craniosynostosis. Indian J Plast Surg 1987;20:1.
Gosain AK, Salyer KE, Arnaud E. Long-term solutions for the delivery of craniofacial care in India and the developing world. J Craniofac Surg 2009;20 Suppl 2:1642-6.
Sharma RK. Craniofacial surgery in a tertiary care center in India. J Craniofac Surg 2014;25:1594-600.
Khanna V, Upadhyaya DN. Future and training in craniofacial surgery in India. J Craniofac Surg 2014;25:1668-70.
[Figure 1], [Figure 2]