Minimally Invasive Sternocleidomastoid Muscle Thinning for Cervical Feminization.

At present, there is no gender-affirming facial surgery that offers feminization of the lateral neck. To demonstrate reliable relationship between the great auricular nerve point (GAP) and spinal accessory nerve along the sternocleidomastoid muscle (SCM) in human anatomical specimens and demonstrate feasibility of muscle transection in one transgender female patient. A total of 14 human anatomical specimen dissections were performed to determine if a transection of the SCM perpendicular to the GAP could be performed without potential compromise of the spinal accessory nerve.

Utility of an Artificial Intelligence Language Model for Post-Operative Patient Instructions Following Facial Trauma.

Study Design: Qualitative Descriptive Study.

Objective: To evaluate the utility of post-operative instructions (POIs) for facial trauma provided by the language model ChatGPT as compared to those from electronic medical record (EMR) templates and Google search engine.

Methods: POIs for four common facial trauma procedures (mandibular fracture, maxillary fracture, nasal fracture, and facial laceration) were generated by ChatGPT, extracted from EMR templates, or obtained from Google search engine.

Impact of Gender-Affirming Rhinoplasty Techniques on Objective Facial Appearance.

Objectives: To evaluate the impact of transfemale gender-affirming rhinoplasty on nasal appearance as evaluated by common facial analysis measures.

Methods: Retrospective case series of patients undergoing gender-affirming nasal surgery at a single tertiary care center from March 2016 to July 2022. Pre- and postoperative photographs were analyzed, using iris width to normalize the measurements.

Cost Comparison of Industry Versus In-House Three-Dimensional Printed Models for Microvascular Mandible Reconstruction.

Computer-aided design and manufacturing can enhance microvascular mandible reconstruction, particularly in cases with preexisting segmental defects or exophytic tumors where precise in situ plate bending is difficult. However, its high cost may limit its use in high-volume academic centers. To compare the costs of industry-performed patient-specific milled locking mandibular reconstruction plates (LMRPs) and surgeon-performed plate bending using 3D-printed (3DP) models as measured by billing data.

Functional and Cosmetic Considerations in Gender-Affirming Feminization Rhinoplasty.

Gender-affirming facial surgery is increasing in prevalence, and rhinoplasty plays an integral role in its success. The nose displays considerable gender dimorphism, and maneuvers performed during gender-affirming rhinoplasty may differ considerably from those performed during cis-gender surgery. During feminization rhinoplasty in particular, cosmetic goals often rely on reductive techniques such as osteotomies, dorsal reduction, sidewall narrowing, tip narrowing, and alar base narrowing.

Objective Photoanalysis of Feminizing Frontal Cranioplasty Outcomes.

Study Design: Retrospective analysis at a tertiary care center.

Objective: This study describes a method of analyzing postoperative results using lateral view clinical photographs to create normalized projection ratios of the glabella and radix.

Methods: We reviewed preoperative and postoperative photographs of 15 patients.

Assessment of Variability in Free Flap Color Match to Facial Skin by Donor Site and Race.

Objectives: To use portable colorimetry to quantify color differences between facial skin and potential three head and neck microvascular free tissue transfer (MFTT) donor sites-radial forearm (RF), anterolateral thigh (ALT), and fibula (FF)-and compare these differences by pigmentation of the donor site skin and self-identified race.

Methods: In this cross-sectional cohort study, healthy volunteers consented to handheld colorimeter measurements at the three potential MFTT donor sites (RF, ALT, FF) to quantify color match to the facial skin using the CIE color space (DeltaE). The comparison of ipsilateral to contralateral cheek served as control for measurements.

Ergonomic Assessment of Septorhinoplasty Maneuvers During Simulated Pregnancy.

Objective: Women represent an increasing proportion of the otolaryngology workforce. Work-related musculoskeletal disorders (WRMSD) are a little-studied yet important impediment to career completion. Scant attention has been directed to study the impact of pregnancy on surgeon posture and ergonomics.

Postoperative inpatient surgical complications following head and neck microvascular free tissue transfer.

Background: Complications following head and neck microvascular free tissue transfer (MFTT) are common. Less is known about when they occur.

Method: Retrospective study of patients with primary or recurrent head and neck cancer undergoing MFTT reconstruction at a tertiary care institution.

Microvascular Free Flap Outcomes in Maxillectomy Defects from Invasive Fungal Sinusitis.

Objectives: Microvascular free tissue transfer is routinely used for reconstructing midface defects in patients with malignancy, however, studies regarding reconstructive outcomes in invasive fungal sinusitis (IFS) are lacking. We aim to describe outcomes of free flap reconstruction for IFS defects, determine the optimal time to perform reconstruction, and if anti-fungal medications or other risk factors of an immunocompromised patient population affect reconstructive outcomes.

Methods: Retrospective review of reconstruction for IFS (2010-2022).

Increasing Pedicle Reach with Musculocutaneous Perforator Dissection in Anterolateral Thigh Free Flaps.

Objective: To measure the increase in effective pedicle reach with microdissection of musculocutaneous perforators during anterolateral thigh (ALT) free tissue harvest.

Methods: A review of our institution's free flap database was performed to identify ALT free tissue transfers. The distance from pedicle vessel origin to its perforator's insertion at the fascia lata (effective pedicle length [EPL]) was measured prior to and following intramuscular dissection of musculocutaneous perforators.

The Impact of Venous Anastomosis Technique on Outcomes of Free Tissue Transfer to the Head and Neck.

To evaluate the impact of different techniques of microvascular venous anastomosis on the outcome of free tissue transfer to the head and neck. Retrospective case series of patients undergoing microvascular free tissue transfer (MFTT) from January 2006 to September 2021. Chi-square tests and -tests were utilized to identify differences in flap outcomes by technique, and log-binomial regression analyses were utilized to identify differences in flap outcomes by technique.

Assessing the Prevalence of Burnout Among Female Microvascular Head and Neck Surgeons.

Research has not explicitly explored differences between male and female microvascular head and neck (MHN) surgeon burnout, which should be identified and addressed to ensure career satisfaction and longevity. To measure and compare the prevalence of burnout among male versus female MHN surgeons. A prospective questionnaire based on the Maslach Burnout Inventory (MBI) was distributed through a web-based survey to the American Association of Facial Plastic and Reconstructive Surgeons and American Head and Neck Society in 2021 and 2022.

Through a New Lens: Skin-Grafted Free Flaps and Objective Facial Skin Color Matching.

Head and neck ablative surgery can impose aesthetic disfigurement, particularly when severe color mismatch exists between native and reconstructed facial skin. To date, the accuracy, objectivity, and modifiability of facial skin color matching remains poorly understood. To measure skin color match outcomes after head and neck reconstruction using handheld colorimetry.

Spherulitic Lead Calcium Apatite Minerals in Lead Water Pipes Exposed to Phosphate-Dosed Tap Water.

Phosphate dosing is the principle strategy used in the United Kingdom to reduce the concentration of lead in tap waters supplied by lead water pipes. The mechanisms of phosphate-mediated lead control are not fully understood, but solid solutions of lead calcium apatite are thought to play an important role. This study investigated the microstructure of a lead pipe, supplied with high-alkalinity tap water, in which the lead calcium apatite crystals were spherulitic having rounded and dumb-bell-shaped morphologies.

Outcomes Associated with Multiple Free Tissue Transfers Performed in a Single Day.

Although microvascular free tissue transfer (MFTT) remains technically challenging, surgeons may need to perform >1 MFTT operations in a given day. To compare MFTT outcomes in cases where surgeons completed one versus two flaps per day by measuring flap viability and complication rates. A retrospective review was conducted of MFTT cases from January 2011 to February 2022 with >30-day follow-up.

Patterns of Postoperative Trismus Following Mandibulectomy and Fibula Free Flap Reconstruction.

The factors that contribute to postoperative trismus after mandibulectomy and fibula free flap reconstruction (FFFR) are undefined. We retrospectively assessed postoperative trismus (defined as a maximum interincisal opening ≤35 mm) in 106 patients undergoing mandibulectomy with FFFR, employing logistic regression to identify risk factors associated with this sequela. The surgical indication was primary ablation in 64%, salvage for recurrence in 24%, and osteonecrosis in 12%.