REGISTRATION NOW OPEN We are pleased to announce that registration is now open for ICOMS 2015. The Conference will be held from 27 – 30 October 2015 at the Melbourne Convention and Exhibition Centre, located in the heart of the world’s most liveable city, Melbourne. Visit the website (www.icoms2015.com.au) now for all the information you will need to assist in your plans – registration, social events, optional tours and accommodation. You don’t want to miss this experience. Please find below an invitation message from the IAOMS President Piet Haers and the ICOMS 2015 Conference Chair David Wiesenfeld.
We look forward to welcoming you to Melbourne in October. Click below for further information
CLICK HERE TO REGISTER
PROGRAM ICOMS 2015 is bringing the world experts in Oral and Maxillofacial Surgery to Melbourne in October 2015. Held over 4 days, the Scientific Program will consist of a combination of plenary sessions, symposia, panel discussions, breakfasts, free paper and poster sessions. Forums designed to allow you to learn, exchange ideas and network with professionals from throughout the world. The international faculty of invited speakers will be announced shortly. Complementing the program will be a series of Pre-Conference Workshops supported by our Industry Partners which will be held in the days immediately preceding the Conference. More information about these opportunities for will be announced shortly. Please visit the website for further information (www.icoms2015.com/program/)
SOCIAL EVENTS To complement the outstanding scientific program, an equally outstanding social program has been developed to allow you the chance to relax, enjoy and experience genuine hospitality whilst you are in Melbourne. Please visit the website for more information (www.icoms2015.com/social-page/)
IAOMS FOUNDATION EVENTS The IAOMS Foundation events held during ICOMS 2015 offer you an outstanding experience whilst making a valued contribution to the Foundation and its programs. Find out more about these events and book via the online registration form to secure your place. (www.icoms2015.com/iaoms-foundation-page/ )
ACCOMPANYING PERSONS We are delighted to invite accompanying persons to the Conference. For more information on the activities on offer please visit the website. (www.icoms2015.com/ registration/accompanyingpersons/ )
CALL FOR ABSTRACTS SUBMIT YOUR ABSTRACT TODAY Held over 4 days, the Scientific Program will consist of a combination of plenary sessions, symposia, panel discussions, workshops and poster sessions. An outstanding selection of invited speakers will be announced shortly. Abstracts are invited for ICOMS 2015, the premier international forum for research, theory and development related to Oral and Maxillofacial Surgery. Held in Melbourne Australia over 4 days, the Scientific Program will consist of a combination of plenary sessions, symposia, panel discussions, workshops and poster sessions.
SPONSORSHIP & EXHIBITION ICOMS 2015 offers a prime opportunity for providers of services and equipment within this specialised field to establish new and consolidate and grow existing networks and relationships. To find out more please visit the website (www.icoms2015.com/sponsorshipexhibition/)
We acknowledge the support of our valued Partners: Platinum Partners ®
M a k e
Gold Partners
Silver Partners
Accepted abstracts will be included in an online supplement of the International Journal of Oral and Maxillofacial Surgery. Click below for further information
PROUDLY SUPPORTED BY
CLICK HERE TO SUBMIT AN ABSTRACT
Please visit the Conference website for further information www.icoms2015.com, or contact WALDRONSMITH Management: 119 Buckhurst Street ❙ South Melbourne VIC 3205 Australia T +61 3 9645 6311 ❙ F +61 3 9645 6322 E ICOMS2015@wsm.com.au ❙ www.icoms2015.com
i t
S i m p l e
Issue 40 / December 2014
Editor-in-Chief Javier Gonzalez Lagunas
Managing Editor Lisa Markovic
Executive Committee 2014 – 2016 Board of Directors Piet Haers, President Kishore Nayak, Past President Julio Acero, Vice President Alexis Olsson, Vice President Elect Robert T.M. Woodwards, Treasurer Larry W. Nissen, Foundation Chairman Pierre Désy, Executive Director
Members-at-Large Gabriele A. Millesi Sanjiv Nair Javier Gonzalez Lagunas
Regional Representatives John Fisher, Africa Kenichi Kurita, Asia Henri Thuau, Europe Alejandro Martinez, Latin American Arthur Jee, North American David Wiesenfeld, Oceania
Committee Chairmen Rui Fernandes, Education Committee Joseph Helman, Research Committee Deepak Krishnan, IAOMST Committee Steve Roser, HADR Committee Fred Rozema, IT Advisory Committee Mark Wong, IBCSOMS Committee Juan Antonio Hueto Madrid, eLearning Sub-Committee
CONTACT US IAOMS
5550 Meadowbrook Industrial Court, Suite 210, Rolling Meadows, IL 60008 U.S.A. 1.224.232.8737 / communications@iaoms.org
Letter from the Editor How
I see it
D
uring training, our residents are exposed to all kind of pathologies in the outpatient clinic and in the operating room. But a key part of their training depends on patients treated in the emergency wards. Every now an then they will have to face, either on their own or with the help of more experienced staff, severe facial injuries; domestic accidents with explosions affecting the face, car accidents with panfacial fractures, gunshot wounds….They are all stressful situations, but working in your own hospital with your colleges and natural environment helps to cope with the situation. This issue is devoted to those oral and maxillofacial surgeons that have worked under extreme circumstances: war, terrorist bombings, natural catastrophes. Not only are they functioning under conditions of stress, but also in a hostile environment, sometimes putting in risk their own personal integrity period. Their work takes place in facilities they could have never imagined to use as an operating room.... Or maybe they have to cope with a cascade of seriously injured patients, requiring all immediate treatment…. The role of war facial injuries has been a key factor in the development of our speciality: the acute stabilization and treatment of the injured, the management of the facial skeleton fractures and soft issues injuries, treatment of sequelae both functional an esthetic….all that is pure maxillofacial surgery. IAOMS, having education as one of its driving forces, can help you. One of our sections, the HADR (Humanitarian Assistance and Disaster Releif) committee, is there to give you solid knowledge on helping casualties of natural disasters, or other situations that require humanitarian relief. . The first step, the course that will be held in Australia during the next ICOMS 2015. Check the webpage of the conference, and get ready to help the others… Javier González Lagunas Editor in Chief
“The role of war facial injuries has been a key factor in the development of our speciality...”
contents december 2014 special report Under pressure
OMS on a mission
Neiva: a comprehensive cleft lip and palate center
so you want to work...
? in India
From Proust to Pivot Julio Cifuentes
copy me
Lower lid blepharoplasty
24 hours
A day in The Life of a senior resident at the university hospital of viena
interview
Dr. Guang-yan Yu
beyond the or
you are? o h w w o Do you kn
Innovation Pierre Désy IAOMS Executive Director
D
uring the Holiday Season, we often reflect on the past year’s accomplishments, personal and professional. Since this is my first opportunity to share my yearly reflections with you, I would like to focus on what immediately stood out above and beyond everything else when I joined IAOMS – passion, dedication, and solidarity. Each person I have interacted with cares deeply about: the advancement of oral and maxillofacial surgery as a science and a profession; patient and delivery of care; IAOMS’ growth and success; and colleagues and friends around the world. I am honored to be part of such a committed professional community. With over 15 years working with non-profits, I have a deep appreciation for dedicated and hard-working volunteers and staff teams. Looking forward, I can assure you that 2015’s theme will be INNOVATION. We are preparing to officially launch our educational webinar series in English, French, and Spanish on topics of high interest. IAOMS will also launch Special Interest Group Networks (SIGNs), mini face-to-face educational conferences on specialized practice topics. In other words, IAOMS will offer you highly valuable continuing education year-round starting in 2015. Similarly, the IAOMS Foundation will launch its first Circles, opportunities to meet with colleagues and friends to practice a favorite activity (i.e., golf, piloting, wine tasting, cultural
experiences, etc.) while increasing awareness and support for the foundation and the impact of OMF surgery on patients worldwide. Needless to say, the upcoming year will be a pivotal year for IAOMS. Personally, I commit to serve you better by keeping you up to date and engaged. I commit to listen to your input to help IAOMS improve its new programs and to guide the development of future great initiatives. Finally, I have a couple of favors to ask: 1. Demonstrate your support by renewing your membership and asking your colleagues to renew/join IAOMS for 2015; 2. Having everyone’s current contact information is key to expanding and improving our communication. You can update your contact information either by calling the office at +1.224.232.8737, emailing us at communications@iaoms.org, or update your profile directly on the IAOMS Website. I also look forward to meeting you all at IAOMS’ 22nd International Conference on Oral and Maxillofacial Surgery (ICOMS), October 27-30, 2015, in Melbourne, Australia. Thank you for reading this short piece. Contact me if you have any questions or would like to discuss ideas you may have- pdesy@iaoms.org Holiday Holidays to you and your loved ones! ■
OMS Family Piet Haers IAOMS President
A
s we prepare to flip our calendars to 2015, I am filled with hope for our future – not only as oral and maxillofacial surgeons, but also as an association. We are on solid ground, on track with our initiatives and we have a capable leadership team to advance IAOMS’s mission on this next leg of our diverse relay. Since the start of my journey this year as your President, I have traveled from Xi’an, China to Melbourne, Australia to Goa, India to name a few. While completing my travels, I was struck by how our common bond is our passion for OMS and our shared cultural values. This connection is why I have called IAOMS home since 1998, and I’m inspired to see a whole new generation of OMS doing the same. IAOMS not only supports our members at work, we are also a family with a worldwide embrace. No matter where you go, you’re not far from IAOMS Fellows who can remind you of why we entered this profession and why we remain committed to it and to each other. It’s a powerful feeling to know that we have over 3,500 colleagues equally dedicated to the mission envisioned by our founders in 1952. So make sure you renew your IAOMS Membership to show your dedication to the specialty. Better
yet, encourage your colleagues to join IAOMS. By increasing our numbers, we increase our voice as oral and maxillofacial surgeons. We hope that you agree that IAOMS has been working hard to bring value to our members through the launch of our Continuing Education Program which includes eLearning and SIGNs, IAOMS biennial conference-ICOMS, IAOMS Fellowship opportunities, and that is just the beginning. As we look towards 2015, we will not be resting on our laurels; more needs to be done as we continue with the initiatives we have set forth to provide our members an educational, professional and social opportunities that will help to strengthen the future and raise the profile of oral and maxillofacial surgery. IAOMS can and will achieve great things for the good of the association. For now, we will take some time to relax and reflect on the meaning of the season, as a time of giving, of happiness, of loving one another, of renewed hope. May the spirit of the season dwell with you all as we celebrate the end of another successful year for IAOMS. I wish you and your families a happy holiday and a very productive and healthy New Year. ■
t r o p e r l a i c spe
Under
pressure Sometimes the circumstances surrounding our work are very adverse. In this issue of F2F, we will approach three life and work experiences in extreme situations where management of stress and solid organization is the key to success.
Are you ready to serve? Dr. Mahiban Thomas Head of the Maxillofacial /Head and Neck Department at the Royal Darwin Hospital. Member of the HADR Committee.
G
iving back to society is something that is in-built in any OMS. It can be a continuing achievement of the best for every patient, a mere desire to do more for the extremely deserving who cannot arrive at your practice or cannot afford such care, a burning passion that carries one to distant lands, or an all-encompassing career in an area of need. Heading off to work at the Bario Pite Clinic, a tiny health facility in Dili, East Timor for just three days, it was not my years of working in India, nor my time in Papua New Guinea, and not even my several weeks in rural Kenya that helped me to plan or prepare for the unknown. Entering a new country, with no language skills, seeking a visa on arrival, driving in an unknown environment, working with a team that I’ve not ever worked with, and working with little or no instruments - all of this is something that I’ve had the privilege of
training towards as a part of the AusMAT course that is run by the National Critical Care and Trauma Response Centre in Darwin in Australia. Learning to negotiate with a hostile immigration officer or raise the periosteum with the back end of any forceps, learning to work with very little in austere settings, and learning to work within constraints that are extremely limited, and to be able to function at a safe level when you are hungry, angry, tired - these are some of the skills, along with most helpful tips both surgical and social - that I gained from this course. Being driven around PNG by a colleague, who had one hand on the wheel and a glass of something stronger than water in the other remains a strong memory. Helping a 24-year old lady from Yemen to eat for the first time in her life (releasing a fibrous union of the right mandible and maxilla following a fall off a roof when she was two years of age) will ever remain etched in my mind from my time in Kenya. Being able to fit into any environment and to function seamlessly with a team that one has just met is a task that requires some training and
IAOMS, Humanitarian Aid the Executive of the IAOMS has rightly established and supported the Humanitarian Aid and Disaster Response Committee. As part of the role of establishing credentials of OMS around the globe to be credentialed responders to sudden onset disasters (SOD), in line with the WHO’s recent documentation in regards to any FMT (Foreign Medical Teams).
preparation. Working on a cleft mission is not the same as responding as an OMS along with the Red Cross/ Crescent or with the International Medical Corps, or as a member of your national medical response team. However, there are similarities, and the Executive of the IAOMS has rightly established and supported the Humanitarian Aid and Disaster Response Committee. As part of the role of establishing credentials of OMS around the globe to be credentialed responders to sudden onset disasters (SOD), in line with the WHO’s recent documentation in regards to any FMT (Foreign Medical Teams) , this Committee has run a course in Santiago in 2011, and will run a very number-limited course in Melbourne in October 2015, just before the start of the ICOMS. The WHO’s document is most applicable for OMS, and Maxillofacial Surgery has been named within the document, as I was involved as a consultant for the
project, and have indeed been acknowledged as such in the guideline. The WHO sees OMS as a secondary responder. Being prepared for the unknown helped the team that travelled to Tacloban after cyclone Haiyan destroyed the entire city earlier this year. Setting up a hospital with a functioning operating theatre, and running it efficiently for three weeks until near normalcy was restored made a major difference to the populace there. Following the WHO’s mandate that only credentialed personnel can be a part of an FMT, OMS need to be prepared. Are you ready to serve? ■
FOUNDATION ACTIVITIES FOR ICOMS2015 22ND INTE R N A T I O N A L C O N FE R E N C E ON ORAL & MAXILLOFACIAL SURGERY
MONDAY 26th OCTOBER
TOUR OF LYON HOUSE MUSEUM and Lunch Lyon house museum is a private home in melbourne with an extensive collection of australian contemporary art. Cost: $150 pp, includes transfers,guided tour and lunch. Time: 1130-1500 hrs -----------------------------------------------------------------------------------------------
THURSDAY 29th OCTOBER
IAOMS FOUNDATION LUNCHEON Proudly sponsored by
Time: 1230 -1400 hrs Melbourne Convention Centre Guest Speaker: Professor Robyn Guymer “THE BIONIC EYE-CAN WE SEE OUR WAY FORWARD?” Inclusions: Two Course Luncheon with wine/soft drinks and presentation. Cost: $150 pp. -----------------------------------------------------------------------------------------------
FRIDAY 30th OCTOBER
KLS MARTIN FOUNDATION GOLF DAY Proudly sponsored by
Time: 1145-1900 hrs Depart/Return Melbourne Convention Centre Cost: $400 pp Inclusions: Transfers, 18 holes Golf at the Victoria Golf Club,shot-gun start, lunch,closing drinks and snacks at 19th Hole. -----------------------------------------------------------------------------------------------
FRIDAY 30th OCTOBER
MCG TOUR and WINE SHOWCASE
Tour of the Melbourne Cricket Ground and Sports Museum with a lunch hosted by a famous Victorian Winemaker,who will speak about her wines. Speaker: Kate McIntyre MW. Moorooduc Wines. Time: 1200-1615 hrs depart Melbourne Convention Centre. Cost: $200 pp Inclusions: Transfers,lunch/ selected Victorian wines,meeting with winemaker and private tour of MCG. -----------------------------------------------------------------------------------------------
FRIDAY 30th OCTOBER
FAREWELL TO MELBOURNE ICOMS2015
DINNER ON THE COLONIAL TRAMCAR RESTAURANT Proudly sponsored by O`Brien Family Foundation Bid Farewell to Melbourne as you dine in one of Melbourne`s historic Colonial Tram Car Restaurants. Enjoy a 5 course meal and quality beverages as you cruise the streets of Melbourne -a unique experience. Time: 2015 for a 2030 hrs departure and 2330 hrs return. Cost: $200 pp
We encourage you to support the IAOMS Foundation www.icoms2015.com by attending the Foundation Activities at the 22nd ICOMS. Register now at www.icoms2015.org
special report
under pressure
A glimpse into Dante’s Inferno Simon Holmes,
Consultant in the Department of Oral and Maxillofacial Surgery in Barts and the London NHS Trust
T
he history of East London is steeped with poverty, violence, crime, political intrigue supported by the pillars of compassion and triumph against adversity. At the centre of the community is the Royal London Hospital, which has provided advanced healthcare to those in whom the need is greatest. Sir Harold Gillies, the father of facial plastic surgery, and Hugh Cairns who forged the mobile military craniofacial unit in North Africa were both on the staff of our hospital group. To this was my beginning. I remember the 7 July 2005 well, it was a beautiful sunny morning, and as I drove past Aldgate East there was clearly significant police activity, a not unusual finding. I was listening to my iPod, and was unaware that there had been three underground trains and one bus bomb detonation. As I arrived in the operating theatre at St Bartholomew’s Hospital I was redirected to the Royal London Hospital as part of the major incident plan, which had just been called. On arrival at the Royal London Hospital the major incident plan had just begun, and I was directed to the triage area. My first memory was of smell of blood, the sounds of suffering, and the way that the resuscitation area had been re-partitioned to accommodate the sudden large number of patients. 208 casualties were
Map of London showing the times and locations of the detonations
received within a four-hour period, 22 of which had significant facial injuries. The medical teams rapidly discharged all patients within the hospital who were safe to go home, and all theatres on standby. Initial involvement in the triage area is centered around anyway provision and arrest of haemorrhage. Walking wounded with facial and scalp lacerations were delegated to appropriate levels of surgeon. My second memory was of the senior general surgeon walking from bed to bed briefing the surgical teams on which legs to remove. I remember seeing a young lady who was about to be taken to theatre for a bilateral lower limb amputation, and this was just the beginning. Initial maxillofacial involvement was targeted at patients requiring control of facial haemorrhage with ligation of vessels, application of packs, and epistats. Prioritized patients were then delegated to surgical teams, and for the next 34 hours all 14 operating theatres worked continuously. The facial injuries were predominantly soft tissue and resulted in numerous grossly contaminated penetrating wounds at different depths involving both organic and non-organic material. Systematic and thorough wound irrigation together with curettage and shop excision of the surgical drains labeled primary closure in most cases. There were significant orbital injuries, and five penetrating eye injuries; one involved removing section of fibula from the orbit. One patient with an extensive craniofacial injury required
“208 casualties were received within a four-hour period, 22 of which had significant facial injuries.”
Queen Elizabeth visiting one of our patients.
Complicated orbital and adnexal injury.
combined neurosurgical and maxillofacial input. Subsequent involvement over the next 12 months enabled me to get to know some patients very well, and I was invited to one patient’s wedding, and saw another in the British Paralympic team. The lifting of the human spirit within the hospital that day, and the sheer determination of the patients subsequently is what I will take from that day, and was exemplified by Queen Elizabeth when she visited, who said that the terrorists chose the wrong city, but the right hospital. â–
Sagittal view showing foreign bodies in the orbit and globe, destroyed orbital floor.
Close-up view showing perforated globe, grossly lacerated upper eyelid.
Completed result at nine months. Note reconstituted upper eyelid with full function. Patient had acute reconstruction of soft tissues, titanium orbital floor replacement, lacrimal duct repair, and secondary globe evisceration. Orbital prosthesis placed at six months.
special report
under pressure
A MAXILLOFACIAL SURGEON
IN THE WAR OF AFGHANISTAN Sergio Ramírez Varela, Maxillofacial surgeon, Madrid (Spain)
S
ergio Ramirez Varela is a maxillofacial surgeon working in the Hospital Universitario de la Defensa in Madrid, Spain. He is also a major of the Spanish Army Force. He was also one of the IAOMS fellows in Cleft Lip & Palate and Craniofacial surgery in South Africa. Two years ago, I to serve as a military surgeon in the war of Afghanistan: that became one of the worst experiences of my life, but it was also one of the most exciting moments I have ever lived. It was
Spanish military camp in afghanistan where we are living with strong snowfall.
Monday November 2nd 2011 and I had just finished my fellowship in South Africa. I was enjoying my holidays with my family, when I received a phonecall from the Ministry of the Defence requesting my immediate incorporation to the operation theatre in Afghanistan. A maxillofacial surgeon was needed to treat war casualties after terrorist attacks against local population and Spanish soldiers. No time to think! . I only had time to prepare all I would need it to do my work under those extreme conditions. The next day I was flying to Afghanistan with a pair of T-shirts, my uniform, a pair of boots, a sleeping bag and some surgical instruments to treat the patients with the best guaranties of success. When we arrived there, the landscape was distressing, we were in a devastated country by the war with snow, cold and humidity; the Spanish troops were in an isolated place in the middle of the mountains. The living conditions were extreme: we were sleeping inside of tents without heating system, the food was not arriving from the military base, and there were no showers due to the cold temperature, ten degrees under zero, that froze the water inside the tanks. My first thought was “What am I doing here?. My mission was to be there for three months and treat all patients (spanish soldiers and local hosts) suffering any injury in the maxillofacial area, but the problem was where would I have to work to do this. The extreme conditions and the place were not optimal so I had to work outside in the operation theatre under the pressure of the islamic troops attacking our positions and our soldiers, with bullets running over our heads in the middle of the desert, explosive artefacts (named ‘Improvised Explosive Devices’ or IED’s) hidden under the land, with cold and snow, and always with the fear in my mind if this day could be my last day. Many war casualties arrived to my position with severe injuries by fire weapons, such as mandible and midface open fractures, neck injuries by bullets with massive haemorrhage, and severe soft tissues traumas by multiple explosive devices.
Earthenware building where the operation room was and we treated to the war casualties.
But I remember one special day. I was treating a child at a small village when we heard a big noise. It was of the explosion of a spanish vehicle with four soldiers that drove over one IED, followed by massive attack by the Taliban’s from the mountains against our soldiers: a rain of bullets began to fall. I received the order to go immediately where the crash occurred and try to save the majority of soldiers. In one minute, we improvised an operation room with the american paramedical helping me with all I would need. We were under a little earthenware building working over a stretcher of wood, with only two sterile sheets, some surgical instruments, anaesthetic drugs, oxygen bomb and all of our efforts to save their lives. I had to operate them very quickly under a big stress because our lives run the risk by the Taliban’s attack. Two of the casualties died at arrival to the operation room due to massive haemorrhage by the bullets through the carotid artery on the neck. Another one had a large soft tissue injury on the face with a mandible fracture and respiratory distress: tracheostomy with debridement of the necrotic tissue plus reduction of the mandible fracture and wire fixation were performed. The last soldier who arrived to the operation room suffered a panfacial fracture with respiratory distress and multiple soft tissues injuries: also tracheostomy and stabilization of all fractures with wires and sutures was done. All patients were treated under local anaesthesia and sedation because of the lack of anaesthetic monitor and time to prepare the best conditions to do it.
➠
“This is a tribute to all victims of the Afghanistan’s war , to their families and to all military doctors who have served there with courage”.
We are treating the patiens with the american paramedical in the operation room.
Both soldiers operated survived and were evacuated by medical helicopter to a military hospital where American military maxillofacial surgeons did the definitive surgical treatment in optimal conditions and out of danger. Several hours later, I was extenuated but the Taliban’s were still shooting fire weapons. Under this hostile landscape we came back to our tents for a rest. Few days later, I received a call phone from this hospital to congratulate us on our efforts and the job we did under those terrible conditions I was imposed medals both by the American and by the Spanish Army. After that day, nothing was the same: I learned to control my fears in extreme situations to make wise surgical decisions and save lives. I cannot say if I will ever repeat another mission in a similar situation, but that´s the life of military surgeons. ■
NEWSLETTER Chairman’s Message THE FUTURE OF THE IAOMS FOUNDATION IS HERE!...
1
The future of the IAOMS Foundation has a new beginning with the generous challenge donation from the KLS Martin Group. The KLS Martin Group has agreed to donate up to $80,000 per year for five years (up to a total of $400,000) providing we receive at least $80,000 per year in donations from our members. This is an unbelievable opportunity for our Foundation and the future of our specialty. BUT December 31, 2014, is the initial deadline by which time we must raise our first $80,000. As of today, we have about 50% of that raised. To those of you who have donated, To those of you who have not, please donate TODAY! Without a total commitment from our Association, we cannot achieve our goals of providing funding for the many important educational opportunities. Also, when you see any of the KLS Martin representatives, please thank them for this generous donation.
THANK YOU.
Larry W. Nissen, Chairman IAOMS Foundation
2
There is also a new face in the home office that dedicates half time to the IAOMS Foundation. Rupa Brosseau, who has extensive experience in the Association world, will be working with me and the Board of Directors to further the goals of the Foundation.
Welcome Rupa to our team!
you. ding a lasting h t i w rts se in need by buil d quality of life a t s e ng h an tho
Cha
helps e healt new dation ove th r n p u o im F s learn h no OMS rgeon ent to u m s n nts wit e o lp The IA e ti ir v a ence. h l n p r il e e id w le a ff n b i d o a n d ti en a ona he sustain ntrym Your d gine t a wide. eir cou h t m I l a . world e h r gift ures to ut you proced witho g n li a f he hope o
Donate Now! iaoms.org/foundation
3
As you can see, the IAOMS FOUNDATION is thriving and on the verge of many new endeavors, but we cannot succeed without
your help.
Please help us meet our goal, donate today. you will consider making your commitment for five years, which will help us receive the entire challenge donation. Thank you!
Hopefully
BUT, WE NEED YOUR HELP IMMEDIATELY!
donate now!
GOAL : $80,000
OMS on a mission Neiva: a comprehensive cleft lip and palate center By David Hoffman, DDS
T
he program in Neiva, Colombia is an annual event that has grown from an initial group of surgeons traveling together to go perform cleft lip and palate surgery in an underdeveloped country to an extremely well planned one-week program that brings together a multidisciplinary team of experts. Of interest to oral and maxillofacial surgeons is the fact that it has become a comprehensive cleft lip and palate center. For instance, each child receives an orthodontic consultation, a speech evaluation, and is included in a genetic research program in collaboration with Columbia University and the genetic team at the University Hospital in Neiva.
The scenes that you witness in Neiva clearly reflect the great need for surgery among children and how the program has become a well-respected cleft lip and palate clinic that services a large number of children each year. Many doctors in both Colombia and Neiva have participated in the program that has now become one of the major events in this city. Hopefully, we can see the Neiva experience repeated throughout our team memberships. This year, Dr. Hoffman invited Pierre DÊsy, IAOMS Executive Director, to come along in the hopes that he could learn about the program and eventually replicate the model as a key initiative of the IAOMS Humanitarian Assistance and Disaster Relief (HADR) committee. The committee is chaired by Dr. Steve Roser, who himself lead a collaborative effort with his chapter of Healing the Children in Nicaragua this past July. Both Dr. Steve Roser and Dr. Larry Harman have been long advocates of promoting volunteer efforts by oral and maxillofacial surgeons and will be part of the ongoing committee to develop this program. The goals of the program are that surgeons will be able to volunteer to travel to underprivileged areas and perform all phases of oral and maxillofacial surgery in conjunction with local doctors who will act as a host team. Because we have such a wide variety of subspecialties within our own specialty, the program may offer many disciplines other than cleft lip and cleft palate. Many local surgeons would like to have guest surgeons come to their community hospitals and hopefully be part of this umbrella organization of volunteers for IAOMS. One of Dr. Hoffman’s goal is to offer IAOMS members the opportunity to volunteer their surgical skills and partner in shared humanitarian assistance efforts to help people in need in underprivileged countries around the world. In the long-term, our greatest hope is that a program such as this one can become recognized as a global effort helping children and people in need throughout the world.
Conquering goals One of the goals that Dr. Hoffman anticipates is that the program will offer members the ability to volunteer their surgical skills, improve partnership in a shared effort to help people in need in underprivileged countries, and increase camaraderie around the world
“The scenes that you witness in Neiva clearly reflect the great need for surgery among children and how the program has become a well-respected cleft lip and palate clinic that services a large number of children each year�.
Initially, we hope to develop a database that includes surgical skill sets, surgical skill level, and desires to either travel or to host a team. Want to get involved? If you are interested in being involved in the volunteer effort please send us an email at communications@ iaom.org and share your interests with us. Tell us whether you would prefer to host a team or volunteer as a surgeon, either as a senior or mentoring level or as a beginner level. â–
So, you want to work...
...in india?
Mumbai
Jaipur
New Delhi
Chennai
receive training in india By Ravi Hebballi. IAOMS Councilor
I
ndia is a land of great opportunities with its amazing history, rich heritage, vast tradition, culture, and geographical attractions which beckon travelers from across the globe.
In the field of medicine and surgery India has made its mark. The best of skills, brains, and technology is available today. Maxillofacial surgery has seen a great transformation and India is on the map for having produced some of the best talent and leaders in the specialty. The 18th ICOMS was hosted in India during 2007, which gave a new dimension to maxillofacial surgery in the country and global recognition to the specialty. With the enormous geographical size of the country and the huge population, there is an abundance of clinical material and unlimited opportunities for training in maxillofacial surgery. With over three hundred dental institutions in the country and the sheer number of maxillofacial surgical cases that are seen across these institutions, it makes it worthwhile for every trainee, clinician, and surgeon to get trained in India. Like in most other countries it is not easy for maxillofacial surgeons to come from another country and work in India. The regulatory body, the Dental Council of India (www.dciindia.org), recognizes certain degrees from overseas. It will grant temporary registrations after a screening test in order to permit specialists from overseas to perform or assist
“With the enormous geographical size of the country and the huge population, there is abundance of clinical material and unlimited opportunities for training in Maxillofacial Surgery.“
procedures in maxillofacial surgery. This facility is limited to institutions and academic centers and not available in the private setup. Various courses offering fellowship and certification in the sub specialty of facial aesthetic surgery, cleft and craniofacial, implantology and oral oncology are available in many universities and institutions. Certain private fellowships and certificate courses in orthognatic surgery are available too. The Dental Council of India permits overseas maxillofacial trainees and surgeons to get trained in the above courses by providing a temporary registration, limited to 3 months. Extensions are possible depending on the length of the course. A degree certificate, registration from the local council, financial documents, letter of invitation from the institution, and proof of accommodation are generally required for getting in to any of these courses. Apart from the training in maxillofacial surgery from some of the best hands in the country, one can also savor the best in hospitality, culture, and food in India. India always welcomes you and we call it “Athithi Devo Bhava” - Guest is God! ■
From Proust to Pivot An Apparently Innocent Questionnaire for Oral and Maxillofacial Surgeons
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ou’ve heard of the Proust Questionnaire Adapted and made famous in the back pages of Vanity Fair Magazine, it was named not for questions, but for the answers given by Marcel Proust to a set of questions asked by his friend Antoinette Faure.
Then, for many years Bernard Pivot conducted a cultural program in french TV called “Apostrophes”. All his guess received the same 10 questions at the end of the interview. So, in Face to Face we thought that being oral and maxillofacial surgeons human beings as the rest, those questionnaites were a great method to let us know some personality traits of our interviewed. Turn the page, enjoy, and discover how Julio Cifuentes answers the IAOMS Proust Questionnaire. Enjoy, and compare their answers with those of celebrities!!!
The IAOMS Proust Questionnaire What is your favorite word? Thank you! What is your least favorite word? No. What is your favorite drug? Chilean red wine. What sound or noise do you love? The sea. What sound or noise do you hate? Traffic. What is your favorite curse word? “Huevón”… Chilean curse word used as noun, adjective, subject, verb… Who would you like to see on a new banknote? Myself!!!! What profession other than your own would you not like to attempt? I would like to be a lawyer! If you were reincarnated as some other plant or animal, what would it be? I would love reincarnate as a Condor, Chile’s largest bird, present in our Andes and in our Patagonia. You get the idea, sort of having a “bird’s view” of the world! If Heaven exists, what would you like to hear God say when you arrive at the Pearly Gates? Welcome and enjoy!! What is your idea of perfect happiness? time alone with my wife! What is your greatest fear? Cancer. What is the trait you most deplore in yourself? Being a bit too self demanding. What is the trait you most deplore in others? Cynicism.
Which living person do you most admire? My mother and my wife. What is your greatest extravagance? Buy clothes and use always the same ones. What is your current state of mind? Motivated. What do you consider the most overrated virtue? Virginity. On what occasion do you lie? Sometimes, white lies. What do you most dislike about your appearance? My belly button…not true, it’s perfect.
Julio Cifuentes is an oral and maxillofacial working in Santiago de Chile and is the Chief of Department in the Clinica Alemana of Santiago. He is a well known speaker in Orthognatfic Surgery and OSAS, is a Past President of The Chilean Association of Maxillofacial Surgery, and was deeply involved in the organization of 21st ICOMS.
What do you consider your greatest achievement? My family and my work. If you were to die and come back as a person or a thing, what would it be? I’d choose to come back as a person! Where would you most like to live? At a beach. What is your most treasured possession? My laptop. What is your favorite occupation? Surgery! What is your most marked characteristic? Perseverance. What do you most value in your friends? Loyalty. Who are your favorite writers? Nicanor Parra, of course. Just turned 100, after receiving the Miguel de Cervantes award. Who is your hero of fiction? Batman. Which historical figure do you most identify with? Ghandi. Who are your heroes in real life? My parents. What are your favorite names? Women’s. What is it that you most dislike? Being forced to do something. What is your greatest regret? No biggie, several small ones.
Which living person do you most despise? Not telling…what if he/she reads this? What is the quality you most like in a man? Loyalty. What is the quality you most like in a woman? They are women, love everything about them. Which words or phrases do you most overuse? “Super!”. What or who is the greatest love of your life? Surgery. My wife answered this one. When and where were you happiest? In my last family vacation at the Chilean Patagonia Which talent would you most like to have? Play an instrument. If you could change one thing about yourself, what would it be? I’d like to be more relaxed.
How would you like to die? Holding a glass of wine and listening to classical music. What is your motto? Push forward. ■
Copy Me Lower lid blepharoplasty Esthetic correction of the eyelids is one of the most common procedures in cosmetic surgery of the face. In this first paper dr Ilankovan will teach you step by step the basic technique of such a popular operation.
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Markings for lower blepharoplasty.
Crows foot inscision.
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Skin flap and muscle exposed.
Skin flap elevation.
Ilanko IIlankovan is the current President of BAOMS, and one of the key figures to bring facial esthetic surgery to the first line of Oral and Maxillofacial Surgery. He works in Poole Hospital in Dorset, as well as in the Wentworth Clinic
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Orbicularis muscle divided.
Skin Closure.
6 Sausage shaped fat exposed.
7 10 Septal reset with anchoring fat to arcus marginarlis with vicryl suture.
8 Excess skin removed.
Pre op.
11 Post op.
Hours A day in The Life of a vienna resident By Dorottya Nemeth (Hungary)
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y name is Doro; I was born in Hungary and have lived almost 3 decades in Hungary. After spending a year in Germany/Heidelberg doing lab research and science as a medical student, I got my degree in human medicine and dentistry in Budapest. Regarding the EU Regulations and the new common EU medical degree, as long as you have some German knowledge, it has been a dream of mine to work as a doctor in Austria as a member of the European Community. The University Hospital in Vienna was my aim, and here I am, a senior resident!
Dra. Doro N emeth is a s enior resident in t he Departme nt of Craniomaxill ofacial Sur gery in the Medical University o f Vienna.
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My long day begins with a small private round to see how my operated patients spent the last night and if they are enjoying the morning view from the 18th floor of the General Hospital of Vienna, a rare chance to sleep at such an altitude for most Viennese people. Our discussion must be kept short; the bell is already ringing for the morning conference.
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The medical staff of our department meets at 7:15 am to discuss our daily program and to make corrections of the OR schedule according to the new admissions during the night. Due to our new workinghour-regulations (you are not allowed to have any patient contact after your night shift), it can be tricky sometimes to find qualified persons for each position, as we have not only 2 operating tables for general anesthesia and 2 tables for local anesthesia each day, but we also have a ward with 42 beds and an ambulance running 24 hours non-stop.
7:30 a.m.
While my colleagues start with the morning round on the ward, I’m heading to the collective pediatric surgical floor to check on our young patients. I gently wake up the 3-year-old girl, by whom I performed my first hard palate closure by Langenbeck the day before. I am really pleased to see that everything is fine; there is no evidence of wound infection or defect. Hopefully, she will not talk and cry too much. To persuade her, I always have some animal stickers in my pocket. That also works if you are frustrated convincing kids about the importance of a blood test and they don’t believe you that it is just like a mosquito pinch.
The Vienna General Hospital (German: Allgemeines Krankenhaus der Stadt Wien) (AKH). Main Entrance.
7:45 a.m. Time to start with our daily “fitness round”running down to the operation theatre on the 9th floor from our inpatient ward on the 18th. The control point already pages you when they start transferring the patient from the recovery room to the OR, and as “sign in contact person” from the surgical side, one needs to speed up, otherwise you are going to get in trouble with the anesthesiologist and have to face the question, “Why are you so slow, my friend?”, my reaction to this question, “I believe I can fly”... I can’t get rid of this song running in my head. Advice to all new candidates: take up base jump training with a parachute in order to avoid these troubles.
8:00 a.m.
Before I start with an operation, I try to recharge my batteries with a sip of water and a bite of my sandwich, which I bought yesterday, as I never get a chance for shopping after the “rush hour” has begun. We are going to perform a bimaxillary osteotomy and genioplasty in a facial asymmetric patient with Prof. Millesi. Orthognathic surgery is the ideal teaching procedure as we, senior residents, can always operate on the left side.
Hours
15:00 p.m.
Other people, having an ordinary job, have already lunch by now, I am heading to our short afternoon conference, then night shift starts... in general we are 3 to 4 doctors on call, one senior and three residents, all sleeping in the hospital. Today I am also having a short seminar with medical students; I need to excuse myself for a 2 hour lecture. I am really glad to have the opportunity to work at the Medical University of Vienna (General Hospital and The Medical University are located in the same building complex), otherwise I would never have a chance to teach students how to make their first surgical knots and practice other surgical technical skills in the lab. They and their patients are lucky‌I made my first skin suture on an 88-year-old patient operated with ileus with shaking hands.
...Anothe r practicin perfect day g charged. a hobby: adrenal ine
19:00 p.m.
Facing the most challenging decision this day: sushi or curry? While we are having dinner with colleagues, we have the possibility to discuss some important daily issues and try to get some tips for our upcoming operations. The senior staff members also like to join this evening session, to share their experience in the OR and give advice. It is good to know, that you have back up.
22:00 p.m.
As a senior resident, you are not only responsible for the microvascular free flaps at the intensive care units, but you also cover the emergency room with the senior staff member. Your pager will also ring for bleedings or airway management at the inpatient ward as well as for simple outpatients with acute tooth ache. And even that at 3 am brings joy to your life! In case of a break, it is time to study for the maxillofacial faculty exam. You are already experienced, nevertheless, time flies, so let’s make our brain brighter, and try to memorize the branches of the external carotic artery and the maxillary artery..... and gosh, I must not miss the deadline to register for the free flap course!!
Horse c arr Schonbr iage near unn pala ce, Vienn Austria. a,
6:00 am Good morning Vienna, let’s enjoy the moment without any flurry of activity, at least for 30 seconds, with a cup of coffee. Although we wake up in the capital of many special coffee types, like Melange, Einspäner etc., you need to be satisfied with an espresso from the machine. The short, warm energy bomb cannot compensate your long night shift in the hospital. Nevertheless, your 24 hour shift is almost over, and you can plan your next day while you are dictating some discharge letters and do the paper work you already postponed for a week. After 11 am I leave the hospital and I try to get some sleep in order to be fit for my evening taebo training. Here you can let off steam and sweat with the combination of kick box, aerobic and very fast music. So when I arrive at home after all, and my boyfriend asks me, how my day was, I reply, “Just Perfect.”
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International Symposium of Piezosurgery Barcelona 2015
October 1 - 3 www.piezosurgery2015.com
Hotel NH Constanza
President IPA: Dr. Domenico Baldi Chairman: Dr. Javier González Lagunas
interview
Prof. Guang-yan Yu “The promotion and education program organized by Asian Association should be conducted in all Asian countries, especially in the developing countries for the near future”.
Please tell us about the history of your Department in Beijing? When did it start and who were your professors? The Department of Oral and Maxillofacial Surgery in the Peking University School of Stomatology was founded in 1955. Prof. Guang-yan Zhang was the first department. How many persons are currently working with you? How many beds do you have? Do you have differentiated sections in it (cancer, trauma, TMJ, orthognahics…? There are currently 53 academic staffs in the department. We have one out-patient clinic with 27 dental units and five in-patient wards with 157 beds. The department is divided into 5 sections including oncologic surgery, trauma, cleft surgery, orthognathic surgery and alveolar surgery. How many patients are you treating yearly in each pathology? There are around 6000 surgical cases per year in the department. In 2013, we treated 3244 oncology cases, 1321 cleft cases, 784 orthognathic cases and 681 trauma cases with the total number of 6030.
Do you promote investigations? Are residents achieving the PhD degree? Which are your “hot” topics now? We do promote investigations for the trainees. Actually the trainees in the department are post-graduate students.They have to finish their research program, submit thesis and pass the oral defense before they are conferred Master/Doctor degree. We enroll PhD students as well. Do you have foreign surgeons training with you? From which countries? If somebody wants to visit your unit, what should they do? Our department has been designated as the International Training Center for the IAOMS Oral
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How is the training for OMFS in China, how many years? Which kind of procedures do they have to do during their training? Five-year clinical training is the standard program for OMFS in China. The rotation program in the subspecialty of alveolar surgery, oral implantology, oral radiology, oral and maxillofacial oncology, trauma, cleft surgery, orthognathic surgery, oral anaesthesiology and general surgery is designed for the trainees.
How many trainees do you have in China? I do not have exact number of trainees in while China. In our department, we enroll around 20 new trainees each year. There are currently 66 trainees in our department.
Professor Guangyan Yu is performing the operation.
and Maxillofacial Oncology and Reconstructive Surgery Training Fellowship Program and AO Craniomaxillofacial Surgery (AOCMF) Fellowship Center. We also enroll fellow recommended by Asian Foundation of Oral and Maxillofacial Surgery. We welcome international surgeons to visit our department as well. We had more than 40 international visitors in the past 5 years. If somebody would like to visit us, please contact Professor Xin Peng, who is in charge of the international affairs. His email address is pxpengxin@263.net. The related information could be found in the website of IAOMS, AOCMF and Peking University School of Stomatology.
▲Executive members of Asian Association of OMS. ▼ Some international trainees with Professor Yu and Professor Peng.
Regarding the Asian Association, we know that you have had very successful meetings….Can you give us some numbers regarding membership: how many members, which are the countries with more members? There are around 3000 members of Asian Association of Oral and Maxillofacial Surgeons. Most members are from Japan, Korea, Chinese Taipei, China, Malaysia, Philippines, Bangladesh, Indonesia, Singapore, Thailand, Iran, India, Hong Kong, Nepal, and other Asian countries. Which are the main difficulties to recruit new members for the Asian association?. Do you have some new project for the near future? New members should be from the developing countries in Asia, but it is still very difficult. The promotion and education program organized by Asian Association should be conducted in all Asian countries, especially in the developing countries for the near future. Your representative in IAOMS Board is really active. How is the relation of Asian Association with IAOMS? Asian Association of Oral and Maxillofacial Surgeons is one part of IAOMS. We would like to play more and more role in the development of global oral and maxillofacial surgery. In 2009, 19th International Congress of Oral and Maxillofacial Surgery (ICOMS)
was held in Shanghai, China. And 23rd ICOMS will be held in Seoul, Korea. If IAOMS wants to have a closer relation with Chinese oral and maxillofacial surgeons, which is your advice? what should we do to have a more participating group of Chinese surgeons in IAOMS ? We also would like to have a closer relation with IAOMS. Promotion program could be conducted in China. More IAOMS training centers, such as centers for cleft surgery and trauma could be established in China. Young colleagues and scholars are welcome to get further training in China. ■
training path for maxillofacial surgery is there a common training path for maxillofacial surgery in all Asian countries? Which are the main differences? There are various training programs and disparate development of medical technology in Asian countries. There will be some regional training center established with the standard training program for the trainee from all Asian countries, which will be the common training path.
Beyond OR Do you know
r who you are?
By Javier González Lagunas
H
you monitoring the social media, your personal and corporate Facebook account, your LinkedIn contacts, or the patient’s forums on professionals? If you do not like what your digital identity is saying about you, is there something you can do to improve it?
In this moment, more than 70% of healthcare customers look for information about their doctors, hospitals and associations through the internet. Are you aware of what the web says about you? When consumers search for you, what are they finding? Are
Start by analyzing your status on the web, get the basic picture that your patients/customers receive when they google your name. Study your brand, but remember that a brand is not a product... A brand is (in the words of Jurgen Salenbacher) a set of qualities and attributes (behavioral, temperamental, emotional and mental) that characterize you as an individual and make you unique and different from others.
opefully you do...but do you have an idea of what your digital identity is? This new term refers to the sum of all digitally available information about an individual. Our digital identity is who we say we are when we are online. This information is steadily growing, so our profile on the internet is amazingly (and sometimes scarily) complete.
Today, in such a competitive market as health related services, you definitely need to have the right strategy to be on the shortlist of your patients. You must be able to show the digital world what makes you different and what makes of you the best choice for your patients... But remember, strategic planning follows a method, and one of the first steps is the internal analysis. Start by analyzing your digital identity!!! ■
“Study your brand, but remember that a brand is not a product... A brand is (in words of Jurgen Salenbacher) a set of qualities and attributes“.
www.iaoms.org/foundation/fellowship/apply/