The Philippine General Hospital Pediatric Neurosurgical and Craniofacial
- Slides: 41
The Philippine General Hospital Pediatric Neurosurgical and Craniofacial Operating Unit PNCOU TO PNCMT
� PNCOU – Pediatric Neuro-Craniofacial Operating Unit � PNCMMT – PGH Neuro Cranio- Maxillofacial Multidisciplinary Team
PNCOU � What is PNCOU? � Joint Operating Unit with Neurosurgery and Plastic Surgery established to treat Pediatric Cranio-Maxillofacial Problems
PNCOU, the story � � � Created a few years ago, PNCOU’s goal was to shorten or eliminate the 2 year waiting backlog of Congenital Neurosurgical patients needing surgery at PGH. This was accomplished by dedicating an Operating room for Hydrocephalic babies, Encephalocoeles, Craniofacial anomalies, Complex cleft lip and palates and brain tumors, and to keep it running 8 hours a day 5 days a week. In order to achieve this, 2 OR nurses and a utility worker have to be paid by private donations at a cost of P 600, 000 a year or roughly $12, 000. The rest of the patient’s basic needs are taken cared of by Philippine General Hospital (Room, basic labs, medications, Physicians). Each year, the office of the PGH Director, Dr Gap Legaspi, would pool donations from different sources and hope that there is enough to keep this project running. When the funds run dry, the room closes and surgeries get delayed. The PNCOU performs around 300 cases a year. Since the inception of PNCOU, the waiting time has been drastically reduced. “Families no longer camp out along Taft Ave, waiting for their turn for surgery”.
What is covered by PNCOU � Cleft Lip and Palate �Naso-alveolar Molding �Primary Repairs
Naso-alveolar Molding Primary Repairs
What is covered by PNCOU � Cleft Lip and Palate �Secondary Repairs �Bone Grafts �Orthognathic Surgeries
Secondary Repairs and Re-repairs
Alveolar Bone Graft
Orthodontics - in cooperation with NCFP* and APO** *NCFP – Noordhoff Craniofacial Foundation, Philippines ** APO – Association of Philippine Orthodontists
Release of Neck Contracture + Orthognathic Surgery + Orthodontics
Orthodontics + Orthognathic Surgery + Abbe Flap + Prosthodontics
Alveolar Bone Graft + Orthodontics + Orthognathic Surgery + Lip Revision with Rhinoplasty using Ear Cartilage Graft
What is covered by PNCOU � Facial Clefts �Primary Repairs �Secondary Repairs �Bone Grafts �Orthognathic Surgeries
Facial Clefts � Disfiguring type of cleft deformity � Involving clefts from the oral area extends to the different facial structures �Cheeks �Nose �Eyes
Facial Cleft – Tessier’s Classification
Pre-op
Post NAM and Post-op
Pre-op with NAM in place
Post-op
Pre-op with NAM in place
Post-op
Pre-op and Post-op
Pre-op and Post-op
Pre-op and Post-op
Pre-op and Post-op
Repair of Facial Cleft + Orthognathic Surgery +Rib Cartilage Graft
Other Congenital Anomalies � Bilateral Cleft Lip and Palate, Mandibular Duplication, Palatal Teratoma
What is covered by PNCOU � Naso-ethmoidal Meningocoele �Intra-cranial repair �Extra-cranial repair �Secondary surgeries
Naso Ethmoidal Meningocoele
What is covered by PNCOU � Craniosynostosis
What is covered by PNCOU � Pediatric Maxillofacial Tumors �Ameloblastoma �Odontogenic Keratocysts
Mandibular Tumors
� We need to progress from PNCOU to PNCMMT � We need a multidisciplinary team � Pediatrician � Pediatric Neurologist � Developmental Pediatrician � Neurosurgeon � Plastic Surgeon � Ear/Hearing Surgeon � Orthodontist � Pediatric Dentist � Speech Therapist � Occupational Therapist