Frontoethmoidal Meningoencephalocele in Cambodia: A Humanitarian Program

Objective. We developed since 2004 a humanitarian teaching program based on a low cost treatment of frontoethmoidal meningoencephalocele and including an evaluation of our results. This craniofacial malformation is frequent in south East Asia with devastating aesthetic and social consequences for affected children. No cause has been detected to date.Methods. This program was facilitated by two nongovernmental organizations: «Children Surgical Center» at Phnom Penh provided the facilities, patients, and local staff and «Médecins du Monde–Opération sourire» provided visiting surgeons twice a year. All operations were free of charge for all patients. Results. Overall, 289 patients were operated (9 years) and 93% of them were seen during follow-up. This follow up remained a challenge because of the local conditions but its strict organization allowed us to show that 77% of the patients were satisfied by the aesthetic results. The most common postoperative issue was a temporary CSF leak. At the end of this program Khmer surgeons were able to treat standard cases without the help of foreigners. Conclusions. This program was selected and totally funded by the «L’Oreal Foundation» and four international papers associating Khmer and French surgeons were published. The development of this humanitarian program allowed several Khmer surgeons to come in France for a complementary teaching program in the fields of Neurosurgery and Facial surgery by a partnership between the Calmette Hospital in Phnom Penh and the CHU of Toulouse.