A Step-by-Step Surgical Technique to the Posterior Auricular "Revolving Door" Flap for Conchal Tumor Excision: A Guide for the Surgical and Dermatological Trainee.

Skin cancer is the most common malignancy worldwide and the auricle is particularly vulnerable to the effects of cumulative sun exposure. Reconstruction of auricular defects after skin cancer excision remains a vexing surgical challenge owing to the complex three-dimensional- anatomy of the external ear, particularly in the conchal bowl. The postauricular island "revolving door" flap is a reliable single-stage method for reconstructing anterior auricular and conchal defects.

Decompressive nerve surgery associated with low diabetic foot ulcer rate and high-risk bias: A systematic review and meta-analysis.

Background: Diabetic sensorimotor polyneuropathy (DSPN) occurs in 50% of diabetes mellitus (DM) patients. Up to 70% of DM patients incur diabetic foot ulcer(s) (DFU). Of those with DSPN, 20% develop DFU and medical therapy remains challenging.

Flap neurotisation improves sensation outcomes in abdominally based autologous breast reconstruction: A systematic review and meta-analysis.

Background: Flap neurotisation is a promising solution to restore the diminished or complete loss of sensation following mastectomy. This systematic review compared sensory outcomes in neurotised versus non-neurotised abdominal-based autologous breast reconstructions to establish its benefit in routine clinical practice.

Methods: A literature search was performed according to the PRISMA guidelines.

Trends and variations in post-mastectomy breast reconstruction rates in Australia over 10 years.

Background: Offering breast reconstruction (BR) at the time of mastectomy is standard of care in Australia with proven quality-of-life benefits. Previously BR rates in Australia have been low compared to similar countries. Accurate up-to-date information is needed to promote equity in access to BR and inform future planning of services.

Facial nerve palsy: Narrative review on the importance of the eye and its assessment.

New solutions are emerging that address specific facial regions in facial nerve palsy (FNP). However the most dreaded consequence of FNP is paralytic lagophthalmos threatening the eye. A way to prioritize these regions is thus required.

Deep inferior epigastric perforator (DIEP) flap safety profile in slim versus non-slim BMI patients: A systematic review and meta-analysis.

Background/purpose: The complications of breast reconstruction using deep inferior epigastric perforator (DIEP) flaps in non-slim patients are well recognized. However, the effects of this surgery performed on slim patients are yet to be consolidated. This study aims to compare the outcomes of performing DIEP flap breast reconstruction in slim and non-slim body mass index (BMI) patients.

Automated Spontaneity Assessment after Smile Reanimation: A Machine Learning Approach.

Background: Recreation of a spontaneous, emotional smile remains a paramount goal of smile reanimation surgery. However, optimal techniques to reliably restore spontaneity remain unknown. Dual automated machine-learning tools were used to develop an objective tool to analyze spontaneous smiling.

Neurotization Preferences in Smile Reanimation: A Discrete Choice Experiment.

Background: Common donor nerve options in smile reanimation include ipsilateral trigeminal motor or contralateral facial nerve branches. Neurotization preference may be influenced by multiple factors, whose relative importance remains poorly understood. In this article, decision-making in smile reanimation is assessed using a stated preference model.

A Patient With Traumatic Upper Eyelid Ectropion and Their Management by Canthopexy.

Upper eyelid ectropion is rare. When it does occur, the cicatricial subset of upper eyelid ectropion is its most common manifestation. Due to its rarity, little has been published regarding its treatment.

Nasolabial fold dynamics: Implications for facial paralysis and facial reanimation surgery.

Objectives: In patients with facial paralysis, facial reanimation surgery may be needed to normalize facial soft tissue function/movements. Critical for this normalization is the dynamics of the nasolabial folds (NLFs). The objective of this prospective, observational study was to determine the 3D morphologic dynamics of the NLFs in patients with unilateral facial palsy and normal subjects.

Toward an Automatic System for Computer-Aided Assessment in Facial Palsy.

Quantitative assessment of facial function is challenging, and subjective grading scales such as House-Brackmann, Sunnybrook, and eFACE have well-recognized limitations. Machine learning (ML) approaches to facial landmark localization carry great clinical potential as they enable high-throughput automated quantification of relevant facial metrics from photographs and videos. However, the translation from research settings to clinical application still requires important improvements.

Spontaneity Assessment in Dually Innervated Gracilis Smile Reanimation Surgery.

Importance: Surgeons have sought to optimize outcomes of smile reanimation surgery by combining inputs from nerve-to-masseter and cross-face nerve grafts. An objective assessment tool could help surgeons evaluate outcomes to determine the optimal neural sources for smile reanimation.

Objective: To evaluate the use of a novel video time-stamping method and standard outcome measurement tools to assess outcomes of facial reanimation surgery using various innervation strategies.

In the Eye of the Beholder: Changes in Perceived Emotion Expression after Smile Reanimation.

Background: Tools to quantify layperson assessments of facial palsy are lacking. In this study, artificial intelligence was applied to develop a proxy for layperson assessments, and compare sensitivity to existing outcome measures.

Methods: Artificially intelligent emotion detection software was used to develop the emotionality quotient.

Patient experience in nerve-to-masseter-driven smile reanimation.

Introduction: The nerve-to-masseter is one of the most frequently used neural sources in smile reanimation surgery. Very little information has been reported on patient experience with regard to reanimated smile usage and sequelae following transfer. The aim of this study was to quantify patient perception of nerve-to-masseter use in smile reanimation surgery.

Using Mobile Text and Media to Complement Teaching in a Facial Reconstruction Training Module in Haiti.

Objectives: (1) To describe electronic communication between global surgeons and trainees in a low-middle income country (LMIC) and to gauge appeal of the WhatsApp platform (2) To introduce a novel intensive ear reconstruction teaching module for surgical capacity building using simulation in a LMIC.

Design: Prospective cohort study.

Setting: University-based medical center in Haiti.

Facial Palsy-Specific Quality of Life in 920 Patients: Correlation With Clinician-Graded Severity and Predicting Factors.

Objectives: To investigate the correlation between facial palsy severity and quality of life in a broad cohort of facial palsy patients and to elucidate factors that influence this relationship.

Study Design: Retrospective study.

Methods: Records of patients presenting with a clinician-graded facial function (eFACE) and facial palsy-specific quality-of-life patient-reported outcome measure (FaCE) scale from the same moment were reviewed.

Outcome Tracking in Facial Palsy.

Outcome tracking in facial palsy is multimodal, consisting of patient-reported outcome measures, clinician-graded scoring systems, objective assessment tools, and novel tools for layperson and spontaneity assessment. Patient-reported outcome measures are critical to understanding burden of disease in facial palsy and effects of interventions from the patient perspective. Clinician-graded scoring systems are inherently subjective and no 1 single system satisfies all needs.

Association of Regional Facial Dysfunction With Facial Palsy-Related Quality of Life.

Importance: Study of the association of regional facial dysfunction with quality of life will lead to a better understanding of quality of life in facial palsy.

Objective: To determine the association of regional facial dysfunction with facial palsy-related quality of life.

Design, Setting, And Participants: This retrospective cohort analysis included patients with flaccid and nonflaccid (synkinetic) facial palsy treated at a tertiary care facial nerve center; the flaccid facial palsy group included 529 patients, and the nonflaccid facial palsy group included 391 patients.

Concomitant Abdominoplasty and Laparoscopic Umbilical Hernia Repair.

Background: Umbilical hernia is a common finding in patients undergoing abdominoplasty, especially those who are postpartum with rectus divarication. Concurrent surgical treatment of the umbilical hernia at abdominoplasty presents a "vascular challenge" due to the disruption of dermal blood supply to the umbilicus, leaving the stalk as the sole axis of perfusion. To date, there have been no surgical techniques described to adequately address large umbilical herniae during abdominoplasty.

Long-term outcome of selective neurectomy for refractory periocular synkinesis.

Objective: The objective of this study was to investigate the long-term effect and treatment stability of selective neurectomy for refractory periocular synkinesis.

Methods: We performed a retrospective review of all patients treated with highly selective neurectomy for refractory periocular synkinesis between August 2009 and August 2015. Primary outcome was time to recommencing treatment for periocular synkinesis.