Hemorrhagic Cervical Synovial Cyst With Atypical Chest Pain Presentation.

Cervical synovial cysts are rare, especially hemorrhagic cervical synovial cysts. The patient was a 58-year-old male with a five-month history of tingling in his right shoulder region, radicular pain in his right arm, and increased pain on the right chest wall that worsened with lying supine down. The patient was diagnosed with a right-sided hemorrhagic synovial cyst at the C7-T1 level.

Management of Complications and Secondary Deformity After Fractures of the Midface, Orbit, and Upper Third of the Maxillofacial Skeleton.

Craniomaxillofacial trauma is a challenging entity to manage effectively and often necessitates serial evaluation and treatment. A multidisciplinary team is best served to evaluate and treat these complex injury patterns with the use of necessary adjuncts, such as neuronavigation, intraoperative imaging, custom implant use, and virtual surgical planning. Complications of facial trauma can present at a spectrum of time points and manifest in a variety of manners and as such patients should be observed closely and longitudinally.

Socioeconomic inequality in the worsening of psychosocial wellbeing disrupted social conditions during COVID-19 among adolescents in Hong Kong: self-resilience matters.

Background: Adolescents, especially the socioeconomically disadvantaged, are facing devastating psychosocial impact of the COVID-19 pandemic during their critical developmental period. This study aims to (i) examine the socioeconomic patterning of the worsening of psychosocial wellbeing, (ii) delineate the underlying mediating factors (i.e.

The Mediating Role of Different Types of Parental Support in the Social Disparity of Hope in Young Adulthood.

Research has shown hope to be associated with a person's well-being, but how it is affected by family factors is unclear. This study investigates whether family socio-economic status (SES) affects young adults' hope, and to what extent and how different types of parental support mediate this social disparity. The data is collected from a sample of Hong Kong youth (N = 760; 54.

Osteoradionecrosis of the Midface and Mandible: Pathogenesis and Management.

Radiation therapy is an important and commonly used treatment modality for head and neck cancers. Osteoradionecrosis (ORN) is a potential debilitating complication of treatment, which most commonly affects the mandible. Management strategies are tailored to the severity of disease.

The Role of External Fixation in Trauma and Reconstruction of the Mandible in the Age of Rigid Fixation.

Internal rigid fixation is the gold-standard treatment for facial fractures, but there are some specific cases that are more amenable to external fixation (ex-fix) application. Herein, we discuss advantages and disadvantages to ex-fix in the modern treatment of comminuted mandible fractures, infected mandible fractures, fractures of the condylar region, oncologic mandibular resection, pediatric mandible fractures, and fractures in the edentulous patient.

Surgical Management of Panfacial Fractures.

The evaluation and management of a patient with panfacial fractures are multifaceted. Herein, we describe basic facial skeletal anatomy, considerations for airway securing, and common concurrent injuries. Finally, we discuss primary and secondary reconstructions of facial trauma including sequencing of repair, available landmarks, and the utility of intraoperative computed tomography imaging and virtual surgical planning with custom implants.

Opioid sparing multimodal analgesia treats pain after head and neck microvascular reconstruction.

Objective: To compare pain control (opioid consumption and postsurgical pain scores) in head and neck (H&N) free flap reconstruction patients who undergo traditional means of postoperative analgesia including use of opioids versus a novel protocol that includes ketamine and gabapentin.

Methods: Single-institution retrospective cohort study.

Results: Eighty-six patients who underwent H&N free flap reconstruction from 2015 to 2018 were included.

Esophageal Perforation due to Anterior Cervical Spine Hardware Placement: Case Series.

This case series discusses surgical management of esophageal perforations that occurred following cervical spine hardware placement. (1) Determine presenting symptoms of esophageal perforation after anterior cervical spine hardware placement. (2) Discuss surgical management of these resulting esophageal perforation complications.

Free-Flap Reconstruction of the Tongue.

The tongue is paramount to natural speech and swallowing, and good tongue function is important in the overall quality of life. Autologous free-flap reconstruction of the tongue after glossectomy allows for adequate speech, swallow, and quality-of-life outcomes in a majority of patients. Herein, the authors review autologous free-flap reconstruction of the tongue with a focus on different flap options, speech and swallow outcomes, quality-of-life outcomes, and factors that affect how patients perform after tongue reconstruction.

Impact of Middle Turbinectomy on Airflow to the Olfactory Cleft: A Computational Fluid Dynamics Study.

Background: The impact of middle turbinate resection (MTR) on olfaction remains a point of debate in the current literature. Few studies have objectively evaluated olfactory cleft airflow following MTR; thus, the mechanism by which MTR may impact olfaction is poorly understood. It is not known whether the postsurgical changes in airway volume, flow, and resistance increase odorant transport or disrupt the patterns of normal airflow.

Higher Complication Rates in Self-Inflicted Gunshot Wounds After Microvascular Free Tissue Transfer.

Objectives/hypothesis: Microvascular free tissue transfer is often employed to reconstruct significant facial defects from ballistic injuries. Herein, we present our comparison of complications between self-inflicted and non-self-inflicted gunshot wounds after microvascular free tissue transfer.

Study Design: Retrospective case review.

Computational Fluid Dynamics to Evaluate the Effectiveness of Inferior Turbinate Reduction Techniques to Improve Nasal Airflow.

Importance: Inferior turbinate reduction (ITR) is a commonly performed procedure for the treatment of nasal obstruction. Which portion of the inferior turbinates should be surgically addressed to improve nasal airflow has yet to be determined.

Objective: To use computational fluid dynamics (CFD) analysis to evaluate the airflow changes after reduction along different portions of the inferior turbinate.

Alopecia Following Bicoronal Incisions.

Importance: Multiple techniques may be used to perform bicoronal incisions, and alopecia is a known postoperative complication of this procedure. To date, no large studies exist comparing alopecia outcomes among bicoronal incision techniques with and without the use of Raney clips.

Objective: To determine (1) whether postoperative alopecia is more common when bicoronal incisions are performed with monopolar cautery, Colorado microdissection tip cautery, or traditional cold steel and (2) whether this outcome is affected by the use of Raney clips.

Facial nerve trauma: evaluation and considerations in management.

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting.

Management of carotid artery trauma.

With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone.

Crumple zone effect of nasal cavity and paranasal sinuses on posterior cranial fossa.

Objectives/hypothesis: Examine a protective crumple zone effect of paranasal sinuses and nasal cavity on skull base fractures.

Study Design: Randomized-control, cadaveric study.

Methods: In the experimental group (n = 4), the nasal cavity and bilateral sinuses of cadavers were obliterated with bone cement, whereas the control group (n = 4) had native sinus architecture.

Injectate volumes needed to reach specific landmarks in s1 transforaminal epidural injections.

Objectives:   We identify the contrast volumes needed to reach specific landmarks during S1 transforaminal epidural injections (S1-TFEIs).

Design:   Prospective, nonrandomized, observational human study. Setting.

Tissue conservation using circular defect with dog-ear deformities excision technique.

Objectives: Compare circular defect with dog-ear deformities excision (CDDE) technique to 3:1 fusiform excision technique when removing facial lesions to analyze which technique provides superior wound closure.

Methods: Identical 1-cm circular skin defects were created on bilateral cheek, forehead, and parietal scalp on three fresh cadavers. Similarly, using four fresh cadavers, identical 2-cm circular skin defects were created on bilateral cheek, forehead, and scalp.

Rhinoplasty for cleft and hemangioma-related nasal deformities.

Purpose Of Review: To provide a concise review of recent articles on rhinoplasty approaches for cleft nasal deformity and nasal hemangiomas published in 2008-2010.

Recent Findings: Cleft nasal deformity rhinoplasty approaches have undergone further refinements as well as new development in techniques and surgical principles to minimize recurrent cleft nasal deformities. There is a paucity of studies addressing cleft septal deformity although there appears to be a greater emphasis on functional outcome in cleft rhinoplasty.

Injectate volumes needed to reach specific landmarks in lumbar transforaminal epidural injections.

Objectives: To identify the volumes of contrast material needed to reach specific landmarks during lumbar transforaminal epidural injections (L-TFEIs).

Design: Prospective, nonrandomized, observational human study.

Setting: Academic/private pain management practice.

An update on hair restoration therapy.

Purpose Of Review: This study is aimed towards clinicians involved in the rapidly developing field of hair restoration. We provide a review of recent literature on this topic.

Recent Findings: Recent studies discussed in this article focus on various aspects of follicular unit transplant surgery, including hairline design and associated complications.

Botulinum toxin a in the treatment of chronic tension-type headache with cervical myofascial trigger points: a randomized, double-blind, placebo-controlled pilot study.

Objective: To evaluate the efficacy of botulinum toxin A (BT-A) as a prophylactic treatment for chronic tension-type headache (CTTH) with myofascial trigger points (MTPs) producing referred head pain.

Background: Although BT-A has received mixed support for the treatment of TTH, deliberate injection directly into the cervical MTPs very often found in this population has not been formally evaluated.

Methods: Patients with CTTH and specific MTPs producing referred head pain were assigned randomly to receive intramuscular injections of BT-A or isotonic saline (placebo) in a double-blind design.

Contrast flow selectivity during transforaminal lumbosacral epidural steroid injections.

Background: Lumbosacral transforaminal epidural steroid injections (LS-TFESIs) are an accepted procedure used in the comprehensive, conservative care for lumbar disc pathology and/or spinal stenosis induced low back pain with a radicular component. Historically, the terminology used to describe the transforaminal technique of instilling medications into the epidural space and/or exiting structures has varied. These procedures have also been referred to as either diagnostic or therapeutic selective nerve root blocks (SNRBs).