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  Craig Murakami, MD, FACS
  Craig Murakami, MD

For one intensive week a year, a U.S. surgical team visits a hospital in Cambodia to assist staff members performing life-changing facial surgeries. Virginia Mason's Craig Murakami, MD, FACS, otolaryngologist and facial plastic surgeon, recently completed his fifth mission as instructor and surgeon with the team at the Khmer Soviet Friendship Hospital in Phnom Penh. Many of the local children who wait for the visiting surgeons each year are suffering from a common birth defect known as microtia: the malformation or absence of an external ear.

In severe cases, a person with microtia may have only a nub of flesh where the ear should be. In the past, there were no treatment options beyond cumbersome prosthetics, which don't work well for a growing child. Reaching school age with the deformity can mean facing constant stares and taunts from other children and battling a lifetime of psychological effects. Dr. Murakami and the team, including an otolaryngologist and surgeon from Seattle Children's, perform reconstructions that seem more miracle than science.

Dr. Murakami explains how a new ear is first fashioned from a piece of the patient's rib cartilage. "We carve four separate pieces during the procedure that are sutured together to create the ear," he says. "We then fit the patient's existing skin over the new ear structure to complete the first surgery." Dr. Murakami points out another surgery is needed later to perform a skin graft for lifting the ear off the head.

"The surgeries are multi-stage procedures, which is why it's so nice to go back to the same place," says Dr. Murakami. "There's a continuity of care that happens working with the same local surgeon."

Some adult patients also receive treatment during the mission, with the team performing rhinoplasties and other revisions for facial deformity present since birth, or brought on by trauma or disease. The hospital covers the cost of care when needed, with help from Face to Face, the humanitarian arm of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Foundation. But just as critical are donations brought by the visiting team, including everything from anesthetics, antibiotics and sutures to repurposed equipment.

"The key is getting the instruments VM donates, such as specialized microscopes, into the right hands," says Dr. Murakami, who notes that the established teaching relationship ensures the equipment is used to its fullest potential. The goal is to provide the Cambodian team with the training and resources to eventually perform the complex surgeries on their own.

Dr. Murakami, who is the father of an adopted son from Cambodia, is inspired by the kids and teenagers he meets on the missions. "Life can be hard for a lot of these kids, but they don't complain," he says. "They are really tough."

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