BFIRST TRIP TO HANOI, VIETNAM
5 -10 February 2023
Location: Department of Plastic Surgery, Viet Duc Hospital Hanoi.
Local Hosts: Dr Nguyen Ha and Dr Tran Huyen
Dr Ken Stewart, Plastic Surgeon
Dr Alex Bennett, ENT/Otologist
Diahann Whitefield, Audiologist
Dr Walid Sabbagh, Plastic Surgeon
Dr Ashesh Bhumkar, ENT/Otologist
Dr Guyrati, Anaesthetist
Approximately 1 in 4,000 babies in Southeast Asia are born with 1 or two missing/barely developed ears in a congenital condition called microtia. This condition is often associated with atresia which is a non-development of the ear canal. The middle and inner ears are usually present, but the sound cannot reach those structures and so the child cannot hear in the affected side. Thus, patients with microtia and atresia suffer from both the stigma of deformity and the disability of deafness. If both sides are affected this is particularly disabling. In addition, the volume of motorbikes in Vietnam and the lack of full-face helmets leads to frequent ear avulsion injuries. These require reconstruction.
On previous missions, Dr Stewart has lead teams of surgeons who have taught the local team the various techniques for reconstruction of the external ear. Clearly, we have sewn seeds on fertile ground as the fantastic local team have learned quickly and have taken these ideas, adapted them to the needs of their local population and now have a very strong ear reconstruction service using single stage surgery. They have quickly become pioneers in endoscopic flap harvest which minimises the scarring for the patient. They have also been assisted on that journey by the Facing the World Charity in the form of assistance in buying endoscopy equipment.
The outstanding issue for their congenital cases was the lack of restoration of hearing. A particular concern for bilateral cases. On this occasion Alex Bennett and Diahanne Whitefield spent much time both in a seminar and face to face clinical meetings teaching on the implant options, exploring local possibilities, and liaising with partner companies to start developing a service.
We now have a clear plan on how to manage those patients going forward and Dr Bennett is planning another trip in October 2023 to teach the team directly regarding the surgical implant techniques.
Deformity due to absent ears can now be very successfully treated in Hanoi. We hope that by the end of 2023 the congenital deafness aspect can also be successfully treated.
In terms of future collaboration with BFIRST we do not feel any further plastic surgery ear reconstruction teaching missions are required from a Vietnamese perspective. They do however desperately need some ear carving gauges and surgical tools and a couple of key textbooks: "Auricular Reconstruction by Francoise Firmin and " Modern Ear Reconstruction" by John Reinisch. As a result of co- sponsorship by Emirates and the Scottish ENT society, the budget is significantly underspent. Therefore, BFIRST have purchased these within the budget and will be delivered by Alex Bennett in October 2023.