Advances in Nonsurgical Periocular Rejuvenation.

Nonsurgical periocular rejuvenation presents varied options to the practitioner. The most common current inject modalities for rejuvenation include hyaluronic acid (HA), platelet-rich plasma (PRP), calcium hydroxyapatite, and poly-L-lactic acid. This article provides a summary of recent publications regarding each injectable as well as the description of pertinent periocular anatomy.

Advances in Nonsurgical Periocular Rejuvenation.

Nonsurgical periocular rejuvenation presents varied options to the practitioner. The most common current inject modalities for rejuvenation include hyaluronic acid (HA), platelet-rich plasma (PRP), calcium hydroxyapatite, and poly-L-lactic acid. This article provides a summary of recent publications regarding each injectable as well as the description of pertinent periocular anatomy.

Prospective Randomized Trial Comparing Opioids versus Nonsteroidal Antiinflammatory Drugs for Postoperative Analgesia in Outpatient Rhinoplasty.

Background: The misuse and abuse of opioids, including overprescription, has led to the current opioid epidemic and national crisis. There is a national effort to eliminate the unnecessary prescription of opioids for analgesia.

Methods: Seventy patients were randomized to receive postoperative analgesia with either 5 mg hydrocodone with 325 mg acetaminophen (opioid control group) or 400 mg of ibuprofen [nonsteroidal antiinflammatory drug (NSAID) experimental group].

Association of Bolster Duration With Uptake Rates of Fibula Donor Site Skin Grafts.

Importance: The fibula free flap donor site is associated with both short-term and long-term morbidity. Split-thickness skin graft (STSG) loss can lead to long delays in donor site healing and is associated with significant adverse sequelae. Patients may experience initial good STSG uptake after bolster removal but may have subsequent partial or total loss related to contact pressure or shearing.

Neuromodulator for the Treatment of Congenital Unilateral Lower Lip Palsy.

Introduction:: Congenital unilateral lower lip palsy is an infrequently encountered condition that manifests as lower lip asymmetry during smiling, laughing, and crying. Treatment options are not well characterized.

Methods:: The authors present the case of a 51-year-old woman who was referred for surgical intervention for facial paralysis.

Undifferentiated pleomorphic sarcoma: Factors predictive of adverse outcomes.

Background: Undifferentiated pleomorphic sarcoma (UPS) encompasses rare neoplasms that can arise either in the dermis or in the subfascial soft tissue. The behavior of UPS ranges from indolent to aggressive, but data predicting outcomes are limited.

Objective: Identify predictors of poor outcomes by analyzing a large collection of UPS cases.

Treatment with anti-Sclerostin antibody to stimulate mandibular bone formation.

Background: Anti-Sclerostin antibody (Scl-Ab) is a promising new bone anabolic therapy. Although anti-Scl-Ab stimulates bone formation and repair in the appendicular and axial skeleton, its efficacy in the craniofacial skeleton is still poorly understood.

Methods: Using an established model of Down syndrome-dependent bone deficiency, 10 Ts65Dn mice and 10 wild-type mice were treated weekly via i.

Otologic Disease Following Palatoplasty In International Cleft Palate Cohort.

Objective: Study the prevalence of otologic disease in a pediatric post-palatoplasty population with no prior ear tube placement in resource-deprived countries and assess patient characteristics associated with these abnormal results.

Design: Retrospective data review.

Participants: Ecuadorian and Chinese children identified during humanitarian cleft lip and palate repair trips with cleft palates undergoing palatoplasty from 2007 to 2010.

Hybrid Cartilage-Modifying Otoplasty Technique and Outcomes.

Importance: Otoplasty is performed to correct prominauris, one of the most common head and neck congenital deformities. Advances in combination hybrid approaches enable surgeons to achieve greater precision and accuracy.

Objective: To describe a hybrid cartilage-modifying approach and evaluate the procedure's effectiveness and safety.

Technical Refinements and Outcomes of the Modified Anterior Septal Transplant.

Importance: Severe anterior septal deviation and resultant nasal obstruction represent a difficult surgical task to correct. The goal of surgery is to straighten the anterior dorsal and caudal struts, while maintaining nasal tip and midvault support. This study presents a novel extracorporeal septoplasty technique to straighten the crooked anterior septum.

Latest advances in the management of facial synkinesis.

Purpose Of Review: To provide an overview of the treatment options for nonflaccid facial paralysis including physical rehabilitation, botulinum toxin injection and surgical intervention. To also describe recent technique advances regarding facial synkinesis in each zone of facial movement.

Recent Findings: Physical therapy and neuromodulation with botulinum toxin continues to be the main treatment strategy for facial synkinesis.

Spontaneous Iliopsoas Hematoma following Microvascular Free Tissue Transfer.

Spontaneous hematoma within the iliopsoas muscle (SIH) is a rare complication most commonly seen in coagulopathic patients. Often, patients undergoing microvascular free tissue transfer are anticoagulated for anastomotic patency. Here we describe two cases of postoperative SIH following contralateral anterolateral thigh (ALT) free tissue transfer for reconstruction of oncologic head and neck defects.

The effect of submandibular gland preservation during level 1B neck dissection on postoperative xerostomia.

Objective: Compare the presence and degree of postoperative xerostomia following preservation or excision of the submandibular gland (SMG) during level IB neck dissection (ND) without adjuvant radiation.

Methods: Retrospective review with patient questionnaire administered to patients with pT1-2N0 oral squamous cell carcinoma (SCC) who underwent resection and ND with SMG preservation or SMG excision without postoperative radiation from 2011 to 2015. We analyzed an additional control group that was age and gender-matched and had not undergone oral resection or SMG excision.

Aesthetics of the Nasal Dorsum: Proportions, Light, and Shadow.

Due to its central location, the nose plays a prominent role in facial aesthetics. As tastes have shifted and techniques have advanced, the accepted "ideal" appearance and proportions of the nose have evolved over time. By assessing the aesthetics of the nasal dorsum through the use of lines and angles, one can more precisely elucidate a goal for the patient's postoperative nasal shape, which should, in turn, guide the surgeon to execute specific operative maneuvers needed to achieve that contour.

Patient perspectives on the barriers associated with medication adherence to oral chemotherapy.

Purpose Appropriate use of oral chemotherapy is a challenge for patients and clinicians. The purpose of this study was to analyze cancer patients' use of oral chemotherapies and identify opportunities to improve adherence. Methods We developed a 30-question survey to address frequency and reasons for reducing/skipping doses; sources of information for oral chemotherapy use; perceived importance of food-drug effects; and ease of understanding labeling directions.

Recent advances in head and neck free tissue transfer.

Purpose Of Review: Free tissue transfer is a versatile and valuable method for reconstructing select head and neck defects following trauma or oncologic resection. Microvascular reconstructive cases are among the longest, most technically challenging, and most labor-intensive operations performed by departments of otolaryngology/head and neck surgery. However, technical advances, increased experience, and robust training programs have permitted realization of microvascular success rates in excess of 97% at most high-volume centers.

The endonasal endoscopic harvest and anatomy of the buccal fat pad flap for closure of skull base defects.

Objectives/hypothesis: Extirpation via expanded endonasal approaches (EEA) to the skull base can result in defects requiring vascularized rotational flap reconstruction. The buccal fat pad (BFP) is a vascularized graft described in open skull base resections, but its harvest and adequacy of vascular supply have not been examined for use with EEA.

Study Design: A transfacial cadaveric dissection was carried forth in a latex-injected specimen to characterize the BFP blood supply.

Safety of cyanoacrylate-based adhesives in creating layered septal cartilage grafts during open structure septorhinoplasty.

Purpose: Patients having suffered severe nasal trauma or having undergone prior septal surgery present particular problems during open structure septorhinoplasty. Septal cartilage deficient noses often require costal or conchal cartilage grafting or the use of allograft material, resulting in secondary donor site morbidity, longer operative times and variable results. The present study evaluated the utility of cyanoacrylate-based adhesives (CBA) in creating layered septal cartilage grafts from remnant septal cartilage for L-strut reconstruction during open septorhinoplasty.

Minimizing morbidity in microvascular surgery: small-caliber anastomotic vessels and minimal access approaches.

Importance: Minimizing morbidity when performing free flap reconstruction of the head and neck is important in the overall reconstructive paradigm.

Objective: To examine the indications and success rates of free tissue transfer using small-caliber facial recipient vessels and minimal access incisions.

Design, Setting, And Participants: Retrospective medical record review of patients with head and neck defects undergoing free tissue transfer from May 2010 to June 2013 at 2 tertiary care academic medical centers.

Cancer pharmacogenomics, adoption by oncologists and patient benefit.

Aim: The study aim was to understand physician experience and factors influencing the adoption of cancer pharmacogenomic (caPGx) testing by oncologists practicing in academic and nonacademic settings.

Method: Anonymous paper surveys were distributed to oncologists practicing in North Carolina (USA).

Results: Although 98% of oncologists see promise in utilizing PGx tests in their practice, few were comfortable with their knowledge (33%) or interpreting test results (37%).

Genomics education for the public: perspectives of genomic researchers and ELSI advisors.

Aims: For more than two decades genomic education of the public has been a significant challenge. As genomic information becomes integrated into daily life and routine clinical care, the need for public education is even more critical. We conducted a pilot study to learn how genomic researchers and ethical, legal, and social implications advisors who were affiliated with large-scale genomic variation studies have approached the issue of educating the public about genomics.

The other half of the story: effect size analysis in quantitative research.

Statistical significance testing is the cornerstone of quantitative research, but studies that fail to report measures of effect size are potentially missing a robust part of the analysis. We provide a rationale for why effect size measures should be included in quantitative discipline-based education research. Examples from both biological and educational research demonstrate the utility of effect size for evaluating practical significance.

Practitioner perspectives on the National Institute of Justice's Violence Against Women Research and Evaluation Program.

Five practitioners who have worked with NIJ over recent years were asked to provide a critique of NIJ's VAW program based on their experience. Individuals from professions that the program seeks to assist or inform offered the following commentaries.