Increasing Incidence of Facial Nerve Disorders in the United States from 2007 to 2022.

Background: Incidence data on Facial Nerve Disorders (FND) and Bell's palsy are currently limited. Prior epidemiological studies have estimated the incidence rate of Bell's palsy to be between 11 and 53/100,000 individuals, although the most cited incidence data are from single regions or municipalities, many of which are outdated from several decades ago.

Methods: This was a retrospective cohort study of US adults from 2007 to 2022 using the Merative™ Marketscan® Research Databases.

Facial Nerve Disorders: Sociodemographic Predictors and Temporal Trends in Dynamic Facial Reanimation in a National Administrative Claims Database.

: Recent surgical innovations have increased treatment options for patients with facial nerve disorders (FNDs), leading to substantial improvements in functional and psychosocial outcomes. However, it is unclear whether sociodemographic factors are associated with the likelihood of undergoing dynamic facial reanimation procedures. : In patients undergoing FND surgical treatment, what sociodemographic variables are associated with undergoing dynamic facial reanimation compared with static facial reanimation within a 16-year period? : This was a retrospective study of adults undergoing surgical management for FND from 2007 to 2022 using the Merative Marketscan Research Databases.

The single-stage melolabial flap for internal lining of full thickness defects of the nasal ala.

Background: Full-thickness defects of the nasal ala necessitate composite repair of the nasal lining, cartilage and soft tissue envelope. Repair of the nasal lining is particularly challenging due to access and geometry of this area.

Objective: To evaluate the melolabial flap as a single stage operation for repair of full-thickness nasal ala defects.

The effect of perichondrium on cartilage graft properties.

Purpose Of Review: The role of perichondrium in cartilage graft survival has been long debated. Although the innate function of perichondrium in providing mechanical and regenerative support to cartilage in its native position is relatively undisputed, studies continue to vacillate over how the perichondrium effects cartilage grafts once transplanted. This review evaluates historical and recent experiments showing how perichondrium may or may not impact graft survival.

Treatment of the Crooked Nose.

The crooked nose is a challenging esthetic and functional problem. The surgeon must carefully evaluate baseline facial asymmetry as well as whether deviation stems from the upper third, middle third, or lower third of the nose. Surgical intervention should be tailored accordingly, with techniques geared toward addressing each deviated section.

Factors Associated with Ocular Injury in Orbital Fracture Patients: Who Requires Urgent Ophthalmic Evaluation?

Create validated criteria to identify orbital fracture patients at higher risk for significant ocular injuries. Determine history and physical examination findings in orbital fracture patients who are associated with ocular injury and warrant urgent assessment by an ophthalmologist. Retrospective chart review of 535 adult orbital fracture patients evaluated at a Level I emergency department between 2014 and 2017, without prior history of orbital fracture, ocular injury, or ocular/orbital surgery.

Quantifying Eye Alignment in Orbital Fracture Patients: The Digital Hess Screen.

Quantifying diplopia to determine management and track outcomes for orbital fracture patients is vital for standardization between visits, physicians, and coordination among the multiple specialties that manage these patients. However, standardization is challenging, as diplopia is often reported subjectively. This study sought to describe the utility of the digital Hess screen in patients with orbital fractures compared with a control group.

The current practice of open neck mass biopsy in the diagnosis of head and neck cancer: A retrospective cohort study.

Objective: To characterize current use of open neck mass biopsy for diagnosis of squamous cell carcinoma in patients presenting with a neck mass.

Methods: Using the University of Michigan Specialized Program of Research Excellence in Head and Neck Cancer patient database (2008-2014), we reviewed patients' referral documentation to identify those who received open neck mass biopsies as part of their squamous cell carcinoma diagnosis. We compared subsequent treatment between patients who did and did not receive an open neck mass biopsy.

Does drug induced sleep endoscopy-directed surgery improve polysomnography measures in children with Down Syndrome and obstructive sleep apnea?

Background: Children with Down Syndrome (DS) and obstructive sleep apnea (OSA) are difficult to treat, as first line therapies may not lead to significant improvement. Drug-induced sleep endoscopy (DISE) directed surgery may be particularly beneficial for these patients.

Objective: To assess change in polysomnography (PSG) measures of patients with DS who underwent DISE-directed surgery.

Is There a Difference in Staging and Treatment of Head and Neck Squamous Cell Tumors Between Tertiary Care and Community-Based Institutions?

Objective: To characterize the differences in the staging and treatment of patients with head and neck squamous cell carcinoma between a tertiary care center and community-based practices.

Methods: This study is a retrospective chart review of 943 adult patients with head and neck squamous cell cancer presenting to a tertiary care center between 2008 and 2014 as part of the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (UM HN-SPORE) database. Demographic information, diagnostic testing, staging information, and treatment recommendations were recorded.

Supraphysiologic control over HIV-1 replication mediated by CD8 T cells expressing a re-engineered CD4-based chimeric antigen receptor.

HIV is adept at avoiding naturally generated T cell responses; therefore, there is a need to develop HIV-specific T cells with greater potency for use in HIV cure strategies. Starting with a CD4-based chimeric antigen receptor (CAR) that was previously used without toxicity in clinical trials, we optimized the vector backbone, promoter, HIV targeting moiety, and transmembrane and signaling domains to determine which components augmented the ability of T cells to control HIV replication. This re-engineered CAR was at least 50-fold more potent in vitro at controlling HIV replication than the original CD4 CAR, or a TCR-based approach, and substantially better than broadly neutralizing antibody-based CARs.

Complications in facial Mohs defect reconstruction.

Purpose Of Review: To review the recent literature in regards to complications after reconstruction of Mohs defects, outline common pitfalls and to discuss the literature on avoiding complications as outlined per aesthetic subunit.

Recent Findings: Complications in facial Mohs reconstruction commonly consist of infection, wound necrosis and dehiscence, hematoma and suboptimal scarring. However, site-specific complications such as hairline or eyebrow distortion, eyelid retraction or ectropion, nasal contour abnormality, alar retraction, nasal valve compromise, significant facial asymmetry or even oral incompetence must also be considered.

Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally.

Objective: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data.

Study Design: Cross-sectional pilot study of institutional census data and a population-based national sample. The setting was primary care and emergency departments at an academic healthcare institution and community healthcare practices nationally.

A humanized mouse model for HIV-2 infection and efficacy testing of a single-pill triple-drug combination anti-retroviral therapy.

While HIV-2 is a causative agent for AIDS in addition to the better studied HIV-1, there is currently no suitable animal model for experimental studies for HIV-2 infection and evaluating promising drugs in vivo. Here we evaluated humanized mice for their susceptibility to HIV-2 infection and tested a single-pill three drug formulation of anti-retrovirals (NRTIs abacavir and lamivudine, integrase inhibitor dolutegravir) (trade name, Triumeq). Our results showed that hu-mice are susceptible to HIV-2 infection showing persistent viremia and CD4 T cell loss, key hallmarks of AIDS pathogenesis.

Complication Rates in Delayed Reconstruction of the Head and Neck After Mohs Micrographic Surgery.

Importance: Same-day Mohs reconstructive surgery is not always possible owing to patient factors, scheduling, and complexity of defect, but there is hesitancy in delaying closure of such defects.

Objective: To describe the frequency of and predictors of complications in patients undergoing delayed facial reconstruction after Mohs micrographic surgery (MMS).

Design, Setting, And Participants: This was a retrospective, multi-institutional cohort study from February 1, 1989, to December 31, 2012.

Humanized Rag1-/- γc-/- mice support multilineage hematopoiesis and are susceptible to HIV-1 infection via systemic and vaginal routes.

Several new immunodeficient mouse models for human cell engraftment have recently been introduced that include the Rag2(-/-)γc(-/-), NOD/SCID, NOD/SCIDγc(-/-) and NOD/SCIDβ2m(-/-) strains. Transplantation of these mice with CD34(+) human hematopoietic stem cells leads to prolonged engraftment, multilineage hematopoiesis and the capacity to generate human immune responses against a variety of antigens. However, the various mouse strains used and different methods of engrafting human cells are beginning to illustrate strain specific variations in engraftment levels, duration and longevity of mouse life span.

Humanized Rag2(-/-)gammac(-/-) (RAG-hu) mice can sustain long-term chronic HIV-1 infection lasting more than a year.

HIV-1 infection is characterized by life-long viral persistence and continued decline of helper CD4 T cells. The new generation of humanized mouse models that encompass RAG-hu, hNOG and BLT mice have been shown to be susceptible to HIV-1 infection and display CD4 T cell loss. Productive infection has been demonstrated with both R5 and X4 tropic strains of HIV-1 via direct injection as well as mucosal exposure.

Mucosal transmission of R5 and X4 tropic HIV-1 via vaginal and rectal routes in humanized Rag2-/- gammac -/- (RAG-hu) mice.

Studies on HIV-1 mucosal transmission to evaluate early events in pathogenesis and the development of effective preventive/prophylactic methods have thus far been hampered by the lack of a suitable animal model susceptible to HIV-1 infection by either vaginal and/or rectal routes. In this regard, while primate-SIV/SHIV and cat-FIV models provided useful surrogate platforms to derive comparative data, these viruses are distinct and different from that of HIV-1. Therefore an optimal model that permits direct study of HIV-1 transmission via mucosal routes is highly desirable.