MEDICAL DIRECTOR DR. AKIRA YAMADA REFLECTS ON TWENTY-FIVE YEARS OF LESSONS LEARNED FROM DR. SALYER ON THE SURGICAL TREATMENT OF CHILDREN WITH CRANIOFACIAL CHALLENGES
Dr. Akira Yamada, a WorldCF medical director and perhaps the foremost ear reconstruction surgeon in the world, is a professor of surgery at Northwestern University’s Feinberg School of Medicine and is on staff at the Ann & Robert H. Lurie Children’s Hospital of Chicago’s Division of Plastic Surgery. He is a native of Japan and was mentored by the WorldCF’s founder Dr. Kenneth Salyer, who died late in 2020. In a tribute to Dr. Salyer published in the Journal of Craniofacial Surgery, Dr. Yamada wrote:
“I learned many things from Dr. Salyer during my fellowship and the twenty year that followed. Here are only a few things I learned from him, and I would like to share them with you:
Previsualization: Dr. Salyer had a background of artistry and possessed extraordinar three-dimensional perception. He taught me the importance of 'previsualization' and 'lights and shadows' as we analyzed and planned craniofacial surgery. Life-size photos of various angles were always hanging in the operating room to help us visualize preoperative goals.
“Safe Surgery: Even though he was open to new technology and new techniques, Dr. Salyer’s priorities were always patient safety. He often emphasized how important it was for craniofacial surgeons to work with excellent pediatric neurosurgeons and anesthesiologists to ensure excellent and safe results.
“Flow state: What makes an experience genuinely satisfying is a state of consciousness called “flow.” During flow, people typically experience deep enjoyment, creativity, and a total involvement with life. Dr. Salyer was often in flow state for cranial vault remodeling, and it was magical to witness him in those moments.
“Pre-planning: Nowadays, it is almost routine for craniofacial surgeons to use life-size skull models for preoperative planning. Dr. Salyer started using this new imaging technology in the 1990s, and he worked closely with Andy Christensen, who founded Medical Modeling. He utilized more than a hundred life-size models donated by Medical Modeling in his world-renowned separation of conjoined Egyptian twins in 2003, and the models were one of the decisive factors in the triumph of the twins’ separation.
“Endless Refinement: Dr. Salyer was never satisfied with current techniques. He always wanted to do better. He was open to new ideas but was only interested in excellent outcomes. If the condition of a patient was out of his area of expertise, or if he felt surgery should be performed by another expert in order to achieve a truly excellent outcome, he was never hesitant to refer the patients to others.
“He was a superb mentor and a great friend, and I will always miss him.”