The Perceived Impact of Global Surgery Engagement on Career Advancement among US Medical Students.

Introduction: There is growing interest among medical institutions to formalize global surgery training. Understanding medical students' perceptions of how global surgery engagement can enhance career advancement is essential for providing appropriate guidance and support for individuals with aspirations in academic global surgery.

Methods: A cross-sectional survey study of US-based medical students from 38 participating schools was performed.

Profileplasty: Comprehensive Facial Profile Management Algorithm Based on 426 Patients.

Objective: Profileplasty traditionally involves improving a nasal hump or an underprojected chin. However, this procedure can correct other facial defects like saddle nose or prognathism. To establish the best overall profile, the nose, the midface, and the chin should be considered altogether.

A National Assessment of Racial and Ethnic Disparities in Cleft Lip Repair.

Purpose: The authors examined the effects of race and ethnicity on the likelihood of experiencing delays to surgery, postoperative surgical complications, and prolonged hospital length of stay (LOS) after primary cleft lip repair.

Methods: Patients who underwent cleft lip repair were identified in the 2006 through 2012 Kids' Inpatient Database. Primary outcomes were defined as treatment after 6 months of age, any surgical complication, LOS greater than 1 day, and total hospital charges.

Altered brain responses to noxious dentoalveolar stimuli in high-impact temporomandibular disorder pain patients.

High-impact temporomandibular disorder (TMD) pain may involve brain mechanisms related to maladaptive central pain modulation. We investigated brain responses to stimulation of trigeminal sites not typically associated with TMD pain by applying noxious dentoalveolar pressure to high- and low-impact TMD pain cases and pain-free controls during functional magnetic resonance imaging (fMRI). Fifty female participants were recruited and assigned to one of three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Graded Chronic Pain Scale: controls (n = 17), low-impact (n = 17) and high-impact TMD (n = 16).

Evaluation of Complication Rates of Free Flap Reconstruction in Pediatric Patients.

Introduction: While there is extensive literature investigating surgical outcomes in free flaps for adults, there is a dearth of information on the efficacy of flap use in the pediatric population. This study is the first to measure complication rates following pediatric free flap reconstruction on a national level.

Methods: All pediatric free flap cases between 2012 and 2018 were identified and stratified by type of flap using current procedural terminology codes assigned to the primary procedure in the National Surgical Quality Improvement Program database.

Longitudinal Outpatient and School-Based Service Use among Children with Nonsyndromic Craniosynostosis.

Background: Although nonsyndromic craniosynostosis has been associated with neurodevelopmental sequelae, a lesser amount of emphasis has been placed on the need for related supportive services. This study assessed the prevalence of such services among children surgically treated for nonsyndromic craniosynostosis and identified predictors of service use.

Methods: Parents of children with nonsyndromic craniosynostosis were recruited from an online craniosynostosis support network and surveyed regarding their child's use of various outpatient and school-based services.

Determining Morbidity of Adding Genioplasty to Bimaxillary Orthognathic Surgery.

Background: Patients with dentofacial anomalies may undergo orthognathic surgery to address functional and aesthetic concerns. Past works have evaluated determinants affecting length of stay (LOS) in patients undergoing upper and/or lower jaw surgery alone. No studies have assessed the addition of genioplasty to double-jaw (Lefort I, bilateral sagittal split osteotomy (BSSO))) surgery and its effect on LOS and other outcomes.

Embracing Allyship in Academic Surgery: How All Surgeons Can Become Effective Champions for Change.

As the surgical community continues to work towards greater diversity, equity, and inclusion, the need for buy-in from all surgeons-including those of the White majority-becomes increasingly apparent. This article invites all surgeons to aid in diversity, equity, and inclusion efforts as "allies," "upstanders," and "champions for change," and provides 2 specific frameworks for enacting allyship within the surgical field. Overt and conscious efforts to embrace allyship are imperative as we seek to fulfill our professional responsibilities to patients and will help create a workplace environment where all persons feel accepted, valued, welcomed, and respected.

Perceived Age and Personality Profiling after Orthognathic Surgery.

Background: Recent studies suggest that orthognathic surgery can improve facial age and personality profiling. The authors expand on these findings by assessing the role of patient facial profile and sociodemographics on perceived changes following surgery.

Methods: Preoperative and postoperative images of 65 patients operated on by a single surgeon were randomly assorted and rated by 30 respondents.

Perceived Age and Attractiveness Using Facial Recognition Software in Rhinoplasty Patients: A Proof-of-Concept Study.

Artificial intelligence (Al)-based analyses may serve as a more objective tool for measuring cosmetic improvements following aesthetic plastic surgery. This preliminary proof-of-concept study utilized a novel commercial facial recognition software to assess perceived changes in age and attractiveness among patients receiving rhinoplasty.This study was a retrospective evaluation of three-dimensional photographs of patients who underwent rhinoplasty by the senior author (DS).

Temporomandibular disorders cases with high-impact pain are more likely to experience short-term pain fluctuations.

Temporomandibular disorders (TMD) patients can present clinically significant jaw pain fluctuations which can be debilitating and lead to poor global health. The Graded Chronic Pain Scale evaluates pain-related disability and its dichotomous grading (high/low impact pain) can determine patient care pathways and in general high-impact pain patients have worse treatment outcomes. Individuals with low-impact TMD pain are thought to have better psychosocial functioning, more favorable disease course, and better ability to control pain, while individuals with high-impact pain can present with higher levels of physical and psychological symptoms.

Development of an Open-Access Webinar Series on Pathways for Global Surgery Engagement for Applicants to US Residency Programs.

Background: Global surgery (GS) training pathways in residency are unclear and vary by specialty and program. Furthermore, information on these pathways is not always accessible. To address this gap, we produced a collection of open-access webinars for senior medical students focused on identifying GS training pathways during residency.

Does Initial Cleft Lip Width Predict Final Aesthetic Outcome?

Unlabelled: A natural aesthetic appearance of the lip and a favorable scar are essential goals of cleft lip repair. Wider clefts intuitively pose a greater technical challenge; however, the relationship between initial width and aesthetic outcome remains controversial. The current study aimed to determine whether lip adhesion can help wider clefts achieve safe, consistent aesthetic outcomes.

Decreasing Inpatient Opioid Use Following Orthognathic Surgery.

Purpose: Strategies to decrease postoperative opioid use are important for mitigating the immediate and long-term risks associated with their use. We aimed to investigate the impact of perioperative various factors on inpatient opioid needs for patients undergoing orthognathic surgery.

Methods: This was a retrospective cohort study of all patients who underwent orthognathic surgery performed by the senior author from 2012 to 2018.

Single-Sided Segmental Maxillary Osteotomies for Alveolar Cleft Deformities.

Although the use of a one-sided segmental maxillary osteotomy has been described for repairing alveolar clefts, there remains little consensus regarding the indications and outcomes of such approaches. This brief clinical note aims to summarize previous studies of one-sided segmental maxillary osteotomies for alveolar cleft (AC) repair. A literature search yielded only 2 articles that described the use of a single-sided segmental maxillary osteotomies (SMO) for AC repair.

Race-Based Differences in the Utilization and Timing of Secondary Cleft Procedures in the United States.

Unlabelled: Primary CL/P repair, revisions, and secondary procedures-cleft rhinoplasty, speech surgery, and alveolar bone grafting (ABG)-performed from 2014-2018 were identified from the Pediatric National Surgical Quality Improvement Program (NSQIP) database. Utilization estimates were derived via univariable and multivariable logistic regression. A Kruskal-Wallis rank-sum test and multivariable linear regression were used to assess differences in timing for each procedure cohort.

Clinical Practice Trends and Postoperative Outcomes in Primary Cleft Rhinoplasty.

Purpose: Optimal correction of the cleft nasal deformity remains challenging. The purpose of this study was to examine the practice patterns and postoperative course of patients undergoing cleft lip repair with rhinoplasty compared to those who have primary lip repair without rhinoplasty.

Methods And Materials: A retrospective cohort study was conducted based on the Kids' Inpatient Database.

Major Complications and Associated Risk Factors for Osseous Genioplasty With Bimaxillary Orthognathic Surgery: An American College of Surgeons-National Surgical Quality Improvement Program Analysis.

Purpose: Patients with significant dentofacial deformities undergoing aesthetic and functional orthognathic surgery may often require genioplasty to advance the position of the pogonion relative to B point. No study to date has evaluated nationally registered data pertaining to addition of osseous genioplasty to bimaxillary orthognathic surgery and its associated clinical outcomes.

Methods: Data was extracted from the National Surgical Quality Improvement Program from 2010 to 2018 using current procedural terminology codes pertaining to Le Fort I osteotomy (LF), bilateral sagittal split osteotomy (BSSO), and osseous genioplasty (G) and divided into 2 cohorts: bimaxillary orthognathic surgery with and without osseous genioplasty.

Utilizing Age of Menarche to Optimize Pediatric Rhinoplasty.

Background/purpose: Pediatric septorhinoplasty has sparked controversial debate amongst craniofacial surgeons, particularly due to its potential growth disturbances of the face and nose. The purpose of this study is (1) to conduct a systematic literature review that explores unique considerations and limitations associated with performing rhinoplasty in the pediatric population; (2) to discuss objective indicators for determining craniofacial skeleton maturation; (3) to perform a case series to further understand whether the age of menarche serves as a good proxy for estimating the time of facial growth maturation, and by extension, whether a post-menarchal patient is a suitable candidate for rhinoplasty.

Methods: Systematic literature review was performed in order to assess unique considerations and limitations of pediatric rhinoplasty.

A Comprehensive Single-Center Analysis of Postoperative Nausea and Vomiting Following Orthognathic Surgery.

Background: Postoperative nausea and vomiting (PONV) remains a major clinical end-point for directing enhanced recovery after surgery (ERAS) protocols in facial plastic surgery. This study aimed to identify risk factors for PONV and evaluate strategies for PONV reduction in orthognathic surgery patients.

Methods: A retrospective cohort study was performed among patients receiving orthognathic surgery at our institution from 2011 to 2018.

The Opportunity Cost of Resident Involvement in Adult Craniofacial Surgery: An Analysis of Relative Value Units.

Purpose: Within the academic surgical setting resident involvement may confer longer operative times. The increasing pressures to maximize clinical productivity and decreasing reimbursement rates, however, may conflict with these principles. This study calculates the opportunity cost of resident involvement in craniofacial surgery.