Introduction
CSC is located in the Kien Khleang National Rehabilitation Center for the disabled in Phnom Penh, Cambodia. [3] Within Cambodia, the organization is registered with the Ministry of Foreign Affairs and International Cooperation, the Ministry of Social Affairs, Veterans and Youth Rehabilitation, and the Ministry of Health.
CSC's Founder and CEO, British-American orthopedic surgeon, Dr. Jim Gollogly first came to Cambodia in 1992 on an assignment with the American Red Cross. He returned in 1998 to start a surgical program for landmine victims. Dr. Gollogly was awarded an Order of the British Empire (OBE) in 2008 for this work in Cambodia. Since its inception, patient numbers have increased from 25 surgeries in its first year to 4,965 free surgeries in 2012, and 6,150 surgeries in 2013. [4] [5] [6]
Services
Once a patient presents to CSC, the medical consultation and surgeries are free of charge. Patients arrive from all over the country for correction of various disabilities and health issues.
Services include:
Orthopedics: Correction of deformities from polio and other infectious diseases, correction of club feet and other congenital abnormalities, treatment of chronic dislocations, malunited fractures and nonunions of fractures, hip replacement, [7] spinal surgery and others.
Ophthalmology: Oculoplastic surgery, correction of strabismus, ptosis, cataract surgery, fitting of artificial eyes, laser and retinal surgery, and others.
ENT: Tympanoplasty, mastoidectomy and ossiculoplasty
Maxillofacial: Cleft lip and palate repairs, [8] facial reconstruction for fractures and traumatic defects, corrections of deformities caused by severe infections such as noma, removal of head and neck tumors, and others.
Plastic Surgery: Treatment of unhealed burn wounds with skin grafts and flaps, release of burn contractures, congenital deformities such as syndactyly, and a wide variety of other procedures to decrease disability and improve appearance and function.
Anesthesia: Local, regional, spinal and general anesthesia, endoscopic intubation, pediatric and adult anesthesia.
Other: CSC performs other specialised procedures such as meningoencephalocele, [9] [10] [11] and fistula repair; [12] and some routine ear, nose and throat procedures.
Post-operative care: Inpatients at CSC stay for varied amounts of time depending on the treatment received. Free meals and clean drinking water are provided throughout the duration of the stay for both the patient and their caretaker/family member. CSC also provides physiotherapy and speech therapy [13] services.
From 2006 - 2019, CSC also partnered with the Cambodian Acid Survivors Charity (CASC) - the only organization in Cambodia working solely with survivors of acid burns. CASC was founded to address the long-term needs of CSC acid burn patients, but due to the decline in prevalence of acid burn patients, CASC closed its doors in 2019. CSC continues to provide treatment to burn patients with Dr. Jim Gollogly acting as the CEO of both organizations. [14]
Training and research
CSC employs 135 staff, including surgeons, nurses, lab technicians, IT, administration, cooks and maintenance personnel. Children's Surgical Centre has partnerships with University of Hong Kong, University of Toronto, [15] University of Washington, Oxford University and University of Bristol, [16] among others. Doctors and health professionals from these institutions, and from around the world come regularly and repeatedly to teach as part of CSC's mission to develop sustainable health services. Additionally, some of the CSC staff are sent abroad for training courses and medical conferences. CSC also hosts final year medical students on elective from around the world.
CSC has articles published in numerous journals, including the Journal of Craniofacial Surgery, [17] Journal of Neurosurgery, [18] Asian Biomedicine, [19] and others.
Trigonocephaly is a congenital condition of premature fusion of the metopic suture, leading to a triangular forehead. The merging of the two frontal bones leads to transverse growth restriction and parallel growth expansion. It may occur syndromic, involving other abnormalities, or isolated. The term is from the Greek trigonon, "triangle", and kephale, "head".
A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate occurs when the palate contains an opening into the nose. The term orofacial cleft refers to either condition or to both occurring together. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disorders.
Sir Archibald Hector McIndoe was a New Zealand plastic surgeon who worked for the Royal Air Force during the Second World War. He improved the treatment and rehabilitation of badly burned aircrew.
Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, and jaws, as well as facial cosmetic surgery.
Otoplasty denotes the surgical and non-surgical procedures for correcting the deformities and defects of the pinna, and for reconstructing a defective, or deformed, or absent external ear, consequent to congenital conditions and trauma. The otoplastic surgeon corrects the defect or deformity by creating an external ear that is of natural proportions, contour, and appearance, usually achieved by the reshaping, the moving, and the augmenting of the cartilaginous support framework of the pinna. Moreover, the occurrence of congenital ear deformities occasionally overlaps with other medical conditions.
Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition.
Orthognathic surgery ; also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, other orthodontic dental bite problems that cannot be easily treated with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries and malproportions where correction can be considered to improve facial aesthetics and self esteem.
Distraction osteogenesis (DO), also called callus distraction, callotasis and osteodistraction, is a process used in orthopedic surgery, podiatric surgery, and oral and maxillofacial surgery to repair skeletal deformities and in reconstructive surgery. The procedure involves cutting and slowly separating bone, allowing the bone healing process to fill in the gap.
Hypertelorism is an abnormally increased distance between two organs or bodily parts, usually referring to an increased distance between the orbits (eyes), or orbital hypertelorism. In this condition the distance between the inner eye corners as well as the distance between the pupils is greater than normal. Hypertelorism should not be confused with telecanthus, in which the distance between the inner eye corners is increased but the distances between the outer eye corners and the pupils remain unchanged.
Encephalocele is a neural tube defect characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull. These defects are caused by failure of the neural tube to close completely during fetal development. Encephaloceles cause a groove down the middle of the skull, or between the forehead and nose, or on the back side of the skull. The severity of encephalocele varies, depending on its location.
ReSurge International, formerly known as Interplast, is the first international humanitarian organization to provide free reconstructive surgery in developing countries, primarily to children with cleft lip and palate and burn scar contractures.
Pierre Robin sequence is a congenital defect observed in humans which is characterized by facial abnormalities. The three main features are micrognathia, which causes glossoptosis, which in turn causes breathing problems due to obstruction of the upper airway. A wide, U-shaped cleft palate is commonly also present. PRS is not merely a syndrome, but rather it is a sequence—a series of specific developmental malformations which can be attributed to a single cause.
Paul Tessier was a French maxillofacial surgeon. He was considered the father of modern craniofacial surgery.
The Cambodian Acid Survivors Charity (CASC) is a non-profit, non-governmental and non-religious organization located in Phnom Penh, Cambodia committed to empowering and supporting survivors of acid burns and eliminating acid violence through legal reform and preventative education.
Macrostomia refers to a mouth that is unusually wide. The term is from the Greek prefix makro- meaning "large" and from Greek στόμα, "mouth".
A jaw abnormality is a disorder in the formation, shape and/or size of the jaw. In general abnormalities arise within the jaw when there is a disturbance or fault in the fusion of the mandibular processes. The mandible in particular has the most differential typical growth anomalies than any other bone in the human skeleton. This is due to variants in the complex symmetrical growth pattern which formulates the mandible.
S. M. Balaji is a dental and Oral and Maxillofacial Surgeon from Chennai, Tamil Nadu, India. He is a dental scientist who specialises in repair of cleft palate, rhinoplasty, ear reconstruction, jaw reconstruction, facial asymmetry correction, dental implantology, maxillofacial surgery and Craniofacial surgery.He is the alumni of prestigious Annamalai University where so many efficient oral and Maxillofacial surgeons are trained.
Malpuech facial clefting syndrome, also called Malpuech syndrome or Gypsy type facial clefting syndrome, is a rare congenital syndrome. It is characterized by facial clefting, a caudal appendage, growth deficiency, intellectual and developmental disability, and abnormalities of the renal system (kidneys) and the male genitalia. Abnormalities of the heart, and other skeletal malformations may also be present. The syndrome was initially described by Georges Malpuech and associates in 1983. It is thought to be genetically related to Juberg-Hayward syndrome. Malpuech syndrome has also been considered as part of a spectrum of congenital genetic disorders associated with similar facial, urogenital and skeletal anomalies. Termed "3MC syndrome", this proposed spectrum includes Malpuech, Michels and Mingarelli-Carnevale (OSA) syndromes. Mutations in the COLLEC11 and MASP1 genes are believed to be a cause of these syndromes. The incidence of Malpuech syndrome is unknown. The pattern of inheritance is autosomal recessive, which means a defective (mutated) gene associated with the syndrome is located on an autosome, and the syndrome occurs when two copies of this defective gene are inherited.
Alveolar cleft grafting is a surgical procedure, used to repair the defect in the upper jaw that is associated with cleft lip and palate, where the bone defect is filled with bone or bone substitute, and any holes between the mouth and the nose are closed.
Hirji Sorab Adenwalla was an Indian missionary who joined the Jubilee Mission in Kerala, India, as a surgeon. Adenwalla turned what was originally a small dispensary into a 1500-bedded medical college and research institute called the Jubilee Mission Medical College. Adenwalla specialized in cleft lip and cleft palate surgeries, providing treatment at low or no cost to more than 21,000 patients. Adenwalla contributed several new techniques to the cleft lip surgery, such as a method to avoid a vermillion notch, a protocol for cleft lip nose correction in unilateral cleft lips, and a procedure for septal repositioning.
Cambodia