Dhaka, Bangladesh & Raichur, India VE Workshop

Happy with our results

Happy with our results
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

We completed ear reconstruction surgery on four children for a variety of congenital ear deformities. These surgeries were all successful without complications. After examining and assuring ourselves that our patients are recovering nicely, we reviewed with Dr. Singh our recommendations for follow-up care. He promised to stay in contact via the internet. We were then treated to a reception where we received recognition plaques from the college president, chief administrator, and Dr. Singh expressing their gratitude to us and Interplast for our visit. We enjoyed our stay and look forward to returning to continue our work here. Happy with our results we began our long journey home.

Carving class

Carving class
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

There were about 40 attendees including residents and students in training. We were impressed with the artistic and technical abilities they demonstrated in the carving class.

Examining patients in Raichur

Examining patients in Raichur
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

After beginning the day with a series of lectures explaining the mission of Interplast and the subject of ear reconstruction, we examined a large number of patients with congenital ear deformities as well as facial burn scar deformities. The clinic was well organized by Dr. Singh and was attended by maxillofacial surgeons from the area and from as far as Nepal.

Arriving in India

Arriving in India
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

Today we arrive in Raichur, India as guests of Dr. Dineash Singh, chairman of maxillofacial surgery at Raichur Dental College. Dr. Dinesh Singh had contacted Interplast asking for help with a large backload of microtia cases. We arrived after a four hour auto ride over marginal roads from Hyderabad. We were very impressed with the operating room and facilities at the college. Although we bring our own instruments and medical supplies we depend on the hosts to provide the medical infrastructure including a clean well ventilated operating room, good lighting, modern anesthesia equipment, a competent anesthesiologist, good monitoring equipment, and a well staffed recovery room. Patient safety is our first priority. Although Raichur is in a remote area in India we felt confident to proceed after we inspected the facility. Tomorrow we will begin with the same schedule that worked so well in Dhaka including a clinic, lectures, and a carving class, followed by two days of surgery.

Feeling honored to help

Feeling honored to help
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

Following surgery a reception and tea were held in our honor at the hospital. We indeed felt honored since this reception was officiated by Dr. Khundhkar, the Minister of Health, the Chief of Surgery, and the President of Dhaka Medical College. They expressed their gratitude for the work Interplast is doing for the children in Bangladesh.

Helping more patients

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

G. R. is a 13 year-old male who previously had undergone two operations by Dr. Khundhkar to reconstruct his congenitally missing right ear.  This morning I and Dr. Khundhkar were able to substantially improve the result by repositioning the ear and revising the scar behind the ear.  After this H.L., a 13 year-old female underwent reconstruction of her congenitally missing left ear by Dr. Leber using her own rib cartilage.

Our first patients

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

J.T. is an 18-year-old female with a severe microtia deformity on her ear. Dr. Leber harvested the 6th, 7th, and 8th rib cartilage from the patient’s right side and sculpted this according to a pattern from the normal right ear.  The cartilage lining (perichondrium) is left in place so it is likely much of this missing cartilage will regenerate. This framework was then placed beneath the skin on the affected side after a space was created. Suction drainage and a bulky protective dressing were applied which will remain in place for one week.  In the afternoon F.R., a 10-year-old female (pictured above) underwent a similar reconstruction of the right ear using rib grafts. Both patients will be up and about tomorrow.  

Evaluating and educating

Evaluating and educating
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

This morning we saw about a dozen cases of microtia mostly in children and young adults. We selected cases for surgery based on several factors. The children need to be at least 8 years old to be suitable candidates for this surgery. Following clinic we presented lectures to the physicians and students about Interplast and the surgical correction of congenital and acquired ear deformities. These same techniques can be used to treat ear deformities that may be acquired through injury or disease. In the afternoon Dr. Leber demonstrated how to carve an ear using potatoes. The students were enthusiastic to try their hand using the materials we provided. In surgery we will be using the patient’s own rib cartilage to form an ear.

Arriving in Dhaka with a plan

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

After two days of flights and an overnight in Delhi, we were welcomed in Dhaka by our host, Dr. Shafquat Khundhkar who runs Interplast’s surgical outreach center in Dhaka.  Tomorrow we plan to examine and select patients for surgery, deliver lectures, and host a “carving workshop.”

Teaching in South Asia

Teaching in South Asia
Originally uploaded by interplast

Dr. Tom Moore and Dr.David Leber, Interplast volunteer visiting educator.

I am Dr. Tom Moore from Indianapolis, Indiana. I am a volunteer plastic surgeon with Interplast. For the past six years I have served as a visiting educator specializing in reconstructing ears for children born with congenitally deformed or missing ears, a condition called microtia. During this time I have visited eight different sites in Bolivia, Ecuador, Peru, and Ghana. This condition is rare, only occurring about once in 5,000 births but appears to be more common in developing countries. Our goal is to teach local plastic surgeons the techniques to treat this problem. Two or three visits to each site are required to demonstrate and teach the surgical stages necessary to complete the reconstruction. Dr. David Leber, a plastic surgeon experienced in international volunteer work in ear reconstruction from Harrisburg, Pennsylvania and I travelled to Dhaka, Bangladesh and then to Raichur, India to conduct seminars on the subject of ear reconstruction.