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GUEST EDITORIAL
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 87-90

Development of craniofacial surgery at postgraduate department of plastic surgery, King George's medical university, lucknow


1 Vice Chancellor, Atal Bihari Vajpayee Medical University, Lucknow, Uttar Pradesh, India
2 Department of Plastic Surgery, King George Medical University, Lucknow, Uttar Pradesh, India

Date of Submission03-May-2021
Date of Acceptance03-May-2021
Date of Web Publication7-Jun-2021

Correspondence Address:
Dr. Harsha Vardhan
Department of Plastic Surgery, King George Medical University, Lucknow - 226 003, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jclpca.jclpca_13_21

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How to cite this article:
Singh AK, Vardhan H. Development of craniofacial surgery at postgraduate department of plastic surgery, King George's medical university, lucknow. J Cleft Lip Palate Craniofac Anomal 2021;8:87-90

How to cite this URL:
Singh AK, Vardhan H. Development of craniofacial surgery at postgraduate department of plastic surgery, King George's medical university, lucknow. J Cleft Lip Palate Craniofac Anomal [serial online] 2021 [cited 2021 Nov 28];8:87-90. Available from: https://www.jclpca.org/text.asp?2021/8/2/87/317778



In 1972, a group of six like-minded surgeons came together to form the International Craniofacial Club, which served as a forum to exchange ideas in the field of craniofacial surgery. This informal club later went on to become the International Society of Craniofacial Surgery. The craniofacial surgeons world over are mourning the recent loss of not one, but two of those founders, who laid the platform for craniofacial surgery in the world, Dr. I. T. Jackson and Dr. Kenneth Salyer. They have been closely associated with the development of craniofacial surgery in India particularly so, in the department of Plastic Surgery at King George's Medical University (KGMU), Lucknow. This article recounts the development of craniofacial surgery in the Postgraduate Department of Plastic Surgery (PGDPS), KGMU and the contribution of these giants to the development of this specialty.

Plastic surgery at KGMU was started in 1962 under the aegis of Dr. R. N. Sharma, as a plastic surgery unit in the department of surgery.[1] In 1971, the department of Plastic Surgery was established as a separate department with postgraduate seats. Craniofacial surgery has been performed since the 1970s in India with Dr. K.S Goleria perhaps the first surgeon to do so.[2] Such procedures were still considered theoretical till an event changed the perception of the senior author.

Dr. Ian Jackson had come to New Delhi to attend the IXth meet of International Plastic Reconstructive and Aesthetic Surgeons in 1987. He agreed to extend his stay and visit the department of Plastic Surgery at Lucknow and demonstrate craniofacial surgery. This was the first time that craniofacial surgery was to be performed at the department. With great anticipation, the host inquired as to the additional requirements regarding craniofacial surgery. His demand surprised the host. All he requested was a simple stainless steel spoon. Armed with this additional stainless steel spoon and a micromotor that Dr. Jackson had brought himself a fronto-orbital advancement was performed.[3] The department realized that all the requirements for performing craniofacial surgery were already present; all that was required was motivation. The senior author performed his first box osteotomy in 1990 and the first fronto-orbital advancement in 1995. In 1997, he visited Dr. Louis Argenta at Raleigh, Dr. Arlen Denny, Arun Gosain at Michigan, and Dr. Ian Jackson at Detroit as part of Plastic Surgery Education Foundation (PSEF) fellowship. Dr. Jackson continued the support to the department by regularly visiting the department [Figure 1] and imparting knowledge to subsequent generations of plastic surgeons in the department, both trainees and the trained. His most recent visit to the department was in 2012 on occasion of the annual conference of the Association of Plastic Surgeons of India (APSICON) [Figure 2].
Figure 1: Dr. Ian Jackson along with Dr. A. K. Singh on his visit to the department

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Figure 2: Dr. Ian Jackson during APSICON 2012

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In 2007 a team of World Craniofacial foundation, comprising of Dr. Kenneth Salyer, Dr. Arun Gosain, and Dr. Eric Arnaud [Figure 3] visited the department. In addition to inspecting the department, they gave lectures and were involved in case planning sessions with not just members of the department but other faculties of the institute as well [Figure 4], [Figure 5], [Figure 6]. They were instrumental in terming the department as a center for excellence for craniofacial surgery. This certification was awarded to three centers, all over India. This gave an impetus not just to the department as more craniofacial surgery was being performed, but the interaction with the eminent teachers encouraged the faculty and trainees in the department, who went on to specialize in craniofacial surgery themselves.
Figure 3: Team of World Craniofacial Foundation

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Figure 4: Team of World Craniofacial Foundation interacting with the faculty and residents

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Figure 5: Planning session with World Craniofacial Foundation team

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Figure 6: Plastic surgery team with Dr. Salyer, Dr. Gosain, and Dr. Arnaud

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Another major contribution to the development of the specialty in the department is that of Dr. Arun Gosain. The senior author visited Dr. Gosain as part of PSEF fellowship in 1997. Dr. Gosain has been a close associate of the department. He first visited the department in 2006 for a craniofacial workshop. He then was part of the team by the world craniofacial foundation in 2007. He along with Dr. Brian Sommerlad attended the national conference of the association of cleft lip and cleft palate (INDOCLEFTCON) organized by the department in 2014 [Figure 7] and [Figure 8]. Several surgeons from the department have subsequently visited him in Chicago. Virtual grand rounds were being held between the Department of Plastic Surgery, Chicago and our department. These meetings, held bimonthly, consisted of case presentations done by both sets of residents along with clinical discussions. These were held in the evening Indian time and early morning American time, demonstrating the commitment of Dr. Gosain toward teaching and betterment of craniofacial surgery all over the world.
Figure 7: Dr. Arun Gosain at INDOCLEFTCON 2014

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Figure 8: Dr. Brian Sommerlad speaking at INDOCLEFTCON 2014

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Due to the efforts of such mentors, at present, PGDPS at the KGMU, Lucknow has been certified as a center of excellence for craniofacial surgery by the Smile train foundation as well. Craniofacial surgery, which was first performed in 1990 by the senior author, has come a long way now. A “Craniofacial Foundation” was formed in 2012 to focus on the development and sustainance of this specialty in India[4] [Figure 9]. The senior author has been a part of the Medical Advisory Board of the World Craniofacial foundation since 2006. He has been an invited speaker in the craniofacial societies of Pakistan, Nepal, and Bangladesh. Prof Rajeev Agarwal visited Dr. Salyer in Dallas Texas on a 1-year fellowship, and Dr. Divya Narayan Upadhya visited Dr. Arun Gosain. These stalwarts have motivated the trainees from the department to take up craniofacial surgery with Dr. G. S. Kalra, Dr. Vaibhav Khanna, and Dr. Devi Mohapatra to name a few, continuing craniofacial care. Numerous articles as well as book chapters have been published from the department on craniofacial surgery.[5],[6],[7],[8],[9],[10] There is a craniofacial laboratory present in the department itself, which is headed by Dr. Veerendra Prasad and Mr. SAJ Zaidi. Planning of surgery, as well as orthodontic support, is hence done in the department itself. Every year, patients from as far as Nepal, Bengal, and Central India come to the department for treatment of craniofacial conditions. At an average 10–15 patients undergo major craniofacial surgery in the department annually. A fellowship in craniofacial surgery has also been granted to the department that is expected to start post the pandemic.
Figure 9: The origin of the “Craniofacial Foundation” with Dr. Goleria, Dr. Jackson, Dr. Sridhar, Dr. Ramesh Sharma, and Dr. Vaibhav Khanna

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  References Top

1.
Singh AK, Bhatnagar SK. History - The saga of development of plastic surgery at K. G.'s Medical University. Indian J Plast Surg 2006;39:212-5.  Back to cited text no. 1
    
2.
Khanna V, Upadhyaya DN. Future and training of craniofacial surgery in India. J Craniofac Surg 2014;25:1668-70.  Back to cited text no. 2
    
3.
Jackson IT, Dubin B, Chandra R, Chabra DK, Singh AK, Kumar P. Craniosynostosis. Indian J Plast Surg 1987;20:1-7.  Back to cited text no. 3
    
4.
Singh AK. Organizing craniofacial surgery teams. Natl J Maxillofac Surg 2020;11:157-8.  Back to cited text no. 4
  [Full text]  
5.
Mohapatra D, Kumar V, Singh AK. Spectrum of primary bone grafting in cranio maxillofacial trauma at a tertiary care centre in India. Indian J Plast Surg 2011;44:29.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Mishra B, Singh AK, Zaidi J, Singh GK, Agrawal R, Kumar V. Presurgical nasoalveolar molding for correction of cleft lip nasal deformity: Experience from northern India. Eplasty 2010;10:e55.  Back to cited text no. 6
    
7.
Singh AK, Upadhyaya DN. Sincipital encephaloceles. J Craniofac Surg 2009;20 Suppl 2:1851-5.  Back to cited text no. 7
    
8.
Rao K, Kumar S, Kumar V, Singh AK, Bhatnagar SK. The role of simultaneous gap arthroplasty and distraction osteogenesis in the management of temporo-mandibular joint ankylosis with mandibular deformity in children. J Craniomaxillofac Surg 2004;32:38-42.  Back to cited text no. 8
    
9.
Prasad V, Singh AK, Kumar V, Mishra B, Upadhyaya D, Nair L. Multidisciplinary treatment focussing on comprehensive orthodontic approach for improving facial esthetics in cleft lip and palate patients. J Cleft Lip Palate Craniofacial Anomalies 2016;3:50.  Back to cited text no. 9
    
10.
Agarwal R, Bhatnagar SK, Pandey SD, Singh AK, Chandra R. Nasal sill augmentation in adult incomplete cleft lip nose deformity using superiorly based turn over orbicularis oris muscle flap: An anatomic approach. Plast Reconstr Surg 1998;102:1350-7.  Back to cited text no. 10
    


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