The Effectiveness of Facial Neuromuscular Retraining on Patients with Facial Nerve Dysfunction: A Mental Health and Quality of Life Analysis.

Facial muscle dysfunction can have drastic psychosocial effects. To evaluate the impacts of customized neuromuscular retraining on mental health, quality of life (QoL), facial muscle function, and synkinesis. Thirty patients with facial nerve dysfunction completed a course of neuromuscular retraining.

Geographic Distribution of Facial Plastic and Reconstructive Surgeons.

Distribution of the general otolaryngology workforce has been described, but not specifically for the facial plastic and reconstructive surgeon (FPRS) workforce. To describe the distribution of FPRS within the United States. The 2022 American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) registry was used to identify active FPRSs.

Quantifying Aerosol Generation in Maxillofacial Trauma Repair Techniques.

Study Design: Cadaveric simulation study.

Objective: The novel coronavirus (COVID-19), which can be transmitted via aerosolized viral particles, has directed focus on protection of healthcare workers during procedures involving the upper aerodigestive tract, including maxillofacial trauma repair. This study evaluates particle generation at different distances from open reduction and internal fixation (ORIF) of maxillofacial injuries in the intraoperative setting to reduce the risk of contracting airborne diseases such as COVID-19.

Mechanical stimulation of a bioactive, functionalized PVDF-TrFE scaffold provides electrical signaling for nerve repair applications.

Traumatic nerve injuries have limited success in achieving full functional recovery, with current clinical solutions often including implementation of nerve grafts or the use of nerve conduits to guide damaged axons across injury gaps. In search of alternative, and complimentary solutions, piezoelectric biomaterials demonstrate immense potential for tissue engineering applications. Piezoelectric poly(vinylidene fluoride-triflouroethylene) (PVFD-TrFE) scaffolds can be harnessed to non-invasively stimulate and direct function of key peripheral nervous system (PNS) cells in regeneration strategies.

Ergonomics in Otolaryngologic Surgery: A State of the Art Review.

Objective: Otolaryngology is a surgical field with a high degree of ergonomic risk. The use of head-mounted lighting, loupe magnification, endoscopes, and microscopes is inherent to the field, coupled with repetitive fine motor movements in a constrained anatomic field as well as static, ergonomically unfavorable postures. We seek to review the otolaryngologic literature on ergonomics, including prevalence, severity, and interventions in decreasing work-related musculoskeletal pain.

Predicting No Show in Voice therapy: Avoiding the Missed Appointment Cycle.

Introduction: Voice therapy plays a critical role in the treatment of voice disorders. Despite positive outcomes in patients who attend voice therapy, otolaryngologists, and speech-language pathologists continue to struggle with patient compliance. Previous studies evaluating the multidisciplinary clinic model have shown better completion, VHI-10 scores, and fewer cancelation and no-shows (NS).

Does Surgical Volume and Complexity Affect Cost and Mortality in Otolaryngology-Head and Neck Surgery?

Objectives: (1) To evaluate whether admission volume and case complexity are associated with mortality rates and (2) evaluate whether admission volume and case complexity are associated with cost per admission.

Study Design: Retrospective case series.

Setting: Tertiary academic hospital.

Fine-Needle Aspiration Utilization for Malignant Thyroid Neoplasms in the Community Hospital Setting: A Quality Improvement Study.

Background: Thyroid nodules are increasingly common. Although guidelines have been published, it is unclear whether recommendations for the use of fine-needle aspiration (FNA) and ultrasonography are followed.

Objective: To evaluate the impact of a quality improvement initiative regarding utilization of FNA and ultrasonography before resection of malignant thyroid neoplasms at a community-based hospital.

Can Predictive Modeling Identify Head and Neck Oncology Patients at Risk for Readmission?

Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study.

Office-based esophageal dilation in head and neck cancer: Safety, feasibility, and cost analysis.

Objective: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA).

Methods: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia.

Association Between Patient Value Systems and Physician and Practice Attributes Available Online.

Importance: The relative value of facial plastic surgeon personal and practice attributes is relevant to the broader health care system because of increasing out-of-pocket expenses to patients.

Objective: To determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients.

Design, Setting, And Participants: This study consisted of an electronic survey sent to patients by email using choice-based conjoint analysis; surveys were sent between December 2015 and March 2016.

Treatment of the periocular complex in paralytic lagophthalmos.

Objectives: Paralytic lagophthalmos can lead to devastating exposure keratitis. The main surgical intervention consists of upper eyelid loading. However, adjunctive lower eyelid and brow procedures are also available as necessary.

Pediatric laryngeal neurofibroma: case report and review of the literature.

Presentation of a case of pediatric laryngeal neurofibroma (LNF) and review of the world literature. Comprehensive review of the world literature using Pubmed and Google scholar. Pediatric LNF was identified in 62 cases reported in the world literature.

Role of secondary intention healing.

Secondary intention wound healing is a simple, yet powerful tool in facial reconstruction. Considered as the most elementary form of wound reconstruction, it is often unused because of concern about the predictability of the result and the desire for immediate reconstruction. Secondary intention wound healing can successfully be used for reconstruction of defects for patients who may not be candidates for involved surgical procedures and should be considered an ideal form of reconstruction for certain defects.

Decision making in nasal reconstruction.

Nasal reconstruction is a challenging and rewarding discipline. The nasal subunit principle dramatically improved the surgeon's ability to reconstruct nasal defects by helping disguise incisions within subunit borders and by providing a tool to help in reconstructive decision making. Selection of the proper reconstruction must include the patient's medicosocial situation and the patient's cosmetic concerns.

The subzygomatic triangle: rapid, minimally invasive identification of the masseteric nerve for facial reanimation.

Background: The masseteric nerve is a valuable donor nerve in the management of facial paralysis; however, its location is less familiar to surgeons because this motor nerve is not commonly exposed in other head and neck procedures. Current techniques for masseteric nerve identification rely on physical measurements from surface or bony landmarks that may be unpredictable across patient age, ethnicity, and size. The authors sought to identify a rapid and minimally invasive technique based on surgical anatomy independent of intraoperative physical measurements.

Algorithmic approach to lower lid blepharoplasty.

The debate continues around transconjunctival versus transcutaneous approaches. Despite the perceived safety of the former, many experienced surgeons continue to advocate the latter. This review aims to present a balanced view of each approach.

Adjunctive fat grafting to the upper lid and brow.

This discussion focuses primarily on lipoatrophy and periorbital deflation in relation to adjunctive fat grafting of the brow and upper eyelid. Like with all clinical information for cosmetic and reconstructive surgeons in this multidisciplinary review of rejuvenation of the brow and upper lid, the authors present anatomy, evaluation, patient expectations, technique, and complications - here, specifically in terms of fat grafting and its associated aspects of fat transfer and relocation and autologous fat, along with hyaluronic acid fillers. Fat harvest and preparation are also described in detail.

Vascularized scapular tip flap in the reconstruction of the mandibular joint following ablative surgery.

We describe a novel design and application of the vascularized scapular tip flap in the reconstruction of a temporomandibular joint and mandibular defect.

Lean management in academic surgery.

Background: Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities.

Sentinel lymph node biopsy is accurate and prognostic in head and neck melanoma.

Background: Sentinel lymph node biopsy (SLNB) has emerged as a widely used staging procedure for cutaneous melanoma. However, debate remains around the accuracy and prognostic implications of SLNB for cutaneous melanoma arising in the head and neck, as previous reports have demonstrated inferior results to those in nonhead and neck regions. Through the largest single-institution series of head and neck melanoma patients, the authors set out to demonstrate that SLNB accuracy and prognostic value in the head and neck region are comparable to other sites.

The role of full-thickness scalp resection for management of primary scalp melanoma.

Background: Scalp melanoma is aggressive and has a proclivity for regional metastasis. We hypothesize that subperiosteal scalp melanoma resection reduces in-transit/satellite recurrence, when compared with subgaleal resection.

Methods: We identified patients with intermediate to deep, primary scalp melanoma referred to head/neck surgery over an 8-year period.

The versatility of the temporoparietal fascia flap in head and neck reconstruction.

Objectives: The temporoparietal fascia flap (TPFF) is a versatile tool in head and neck reconstruction. This article aims to describe the spectrum of TPFF applications through a series of case studies and related review of the literature.

Methods: Medical records were reviewed to identify cases that represent major TPFF application categories.

Reconstructive perspectives of cutaneous defects involving the nasal tip: a retrospective review.

Objectives: To create an algorithm that derives our preferred reconstruction technique for cutaneous defects involving the nasal tip and to review the management and outcomes of patients with nasal tip cutaneous defects after their initial reconstruction.

Methods: A retrospective review of patients undergoing repair of cutaneous defects involving the nasal tip between January 2006 and January 2009. After data compilation, a defect-based algorithm deriving our repair technique was created.