Highlights of the Proceedings from the 12th International Congress of the International Society of Craniofacial Surgery: ISCFS 2007

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The 12th International Congress of the International Society of Craniofacial Surgery took place in Salvador, Brazil, from August 23 to August 25, 2007, and was hosted by Anthony Wolfe, MD, and Vera Raposo do Amaral. This meeting marked the 24th anniversary of the Society and, more significantly, the 40th anniversary of craniofacial surgery. Throughout the 3 days spanning this conference, comprehensive and compelling discourse over contemporary practice transpired, with enthusiasm evident surrounding the evolution of present approaches and future techniques. From opening panel sessions to the conference's concluding discussion on facial transplantation, stimulating, provocative discussion took place, highlighting the rich diversity and ingenuity that the Congress has come to embrace. With the recent loss of Cassio Raposo do Amaral, recently elected president of the International Congress of the International Society of Craniofacial Surgery, the 12th Congress served as a fitting tribute to his memory.1,2
Borrowing on experiences gained from a year spent with Paul Tessier, Cassio returned to Brazil in 1974 to establish not only a plastic surgery unit at State University of Campinas, but also SOBRAPAR, an independent center solely devoted to craniofacial surgery (Fig 1). Building this charitable institution into a world-class hospital, Cassio's achievements and contributions were unquestionably inspiring and underscored the widespread impact and innovative nature of craniofacial surgery. Presently, Vera Raposo do Amaral successfully runs SOBRAPAR. Cassio's eldest son, Cassio Edwardo do Amaral, has finished fellowship training and recently returned as director of SOBRAPAR's multidisciplinary team. In addition, Cassio's other son, Cesar Augustus do Amaral, is presently training in the plastic surgery residency program his father established. Today, SOBRAPAR performs 1200 cases/y (approximately 24 intracranial) and has more than 150 patients waiting for major reconstruction. A number of plastic surgeons have made contribution fundamental to SOBRAPAR, and some of these include John Marquis Converse, Paul Tessier, Henry K. Kawamoto, Hugo Obwegesser, Anthony Wolfe, Joseph G. McCarthy, Bengt Johnson, Mutaz B. Habal, James P. Bradley, and McKay McKinnon. After the introduction to the meeting, Cassio's remarkable work was highlighted with a series of case presentations by his eldest son Cassio. In addition, a taped eulogy by Dr. Tessier described Cassio as a genuine, honest person and friend.
The Congress was opened by Dr. Wolfe with a presentation on the legacy of Paul Tessier, from his early incorporation of autologous bone grafting to the first transcranial approach for midface surgery. Long considered the criterion standard of craniofacial surgery, Paul Tessier's results served as a fitting backdrop for subsequent critical examination of more modern concepts discussed at the Congress. During 3 days in Salvador, this same enthusiasm and pioneering spirit of both Paul Tessier and Cassio Raposo do Amaral were echoed in a multitude of presentations (Fig 2).
Work described in the scientific sessions revealed continued refinement in our understanding of bone morphogenetic protein (BMP) biology and its cautiously expanding role in the clinical arena. Although interest over the use of adipose-derived stromal cells has somewhat waned, a multitude of studies demonstrated the efficacy of BMPs in promoting endogenous bone tissue engineering. Whether through antagonist manipulation or direct application, BMPs were shown to dramatically promote repair of calvarial defects in animal models. Furthermore, clinical use of BMPs was described as alternative therapy with good results in the treatment of alveolar clefts, mandibular reconstruction, and repair of hemicranial bone defects. These reports clearly demonstrate a growing need for regulated clinical studies of the osteoinductive capacity of this cytokine and heighten interest surrounding its potential use not only in the craniofacial skeleton but also at other sites of bony need throughout the entire body.
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