Reducing Surgical Risks for Otoplasty.

Prominauris is a common auricular deformity most often due to underdevelopment of the antihelical fold or overdevelopment of the conchal bowl. Significant psychosocial distress may result from prominent ears, leading to the development of a variety of surgical techniques over the years. A thorough understanding of the anatomy of both the normal and prominent ear is crucial for accurate analysis and surgical correction of the deformity.

Computer assisted skull base surgery: a contemporary review.

Skull base surgery has evolved significantly since Harvey Cushing's first descriptions in the early 1900s. Computer aided surgery (CAS) applications continue to expand; they include virtual surgical planning, augmented and virtual reality, 3D printing of models/cutting guides/implants, surgical navigation, and intraoperative imaging. The authors will review the current skull base CAS literature and propose a computer aided surgical workflow categorizing these applications into 3 phases: 1) Virtual planning, 2) Surgical execution, 3) Intraoperative verification.

Frontal Sinus Fractures: A Contemporary Approach in the Endoscopic Era.

Although frontal sinus fractures are relatively uncommon, the potential for long-term morbidity is significant. Management strategies remain controversial due to a lack of strong clinical evidence. Despite a paucity of strong literature, a logical treatment algorithm is presented based on the structural integrity of three anatomic parameters: anterior table, frontal sinus outflow tract, and the posterior table/dura.

Successful Hypoglossal Nerve Upper Airway Stimulator Implantation After Chemoradiotherapy for Oropharynx Malignancy Complicated by Mandibular Osteoradionecrosis.

This case demonstrates the first successful treatment of obstructive sleep apnea with hypoglossal nerve upper airway stimulation in a patient with prior radiation for oropharynx cancer complicated by osteoradionecrosis of the mandible.

Reconstruction technique following total laryngectomy affects swallowing outcomes.

Objectives: How reconstruction affects function following total laryngectomy is unclear. This study seeks to determine whether reconstruction method is associated with differences in swallowing outcomes.

Methods: Retrospective review of reconstruction technique in patients undergoing TL was compared by pharyngeal transit time (PTT), patient-reported dysphagia (EAT-10), and diet-tolerated (FOIS).

Nerve grafts in head and neck reconstruction.

Purpose Of Review: This article reviews recent literature on repair of peripheral nerve injuries in the head and neck with a focus on autografts, allografts, nerve conduits, and technical considerations.

Recent Findings: Contemporary nerve grafting techniques offer the potential to improve peripheral nerve outcomes and reduce donor site morbidity. A variety of donor nerves autografts have been described that offer favorable outcomes for segmental reconstruction of facial nerve defects.

Controversies in Cleft Rhinoplasty.

Rhinoplasty for cleft lip nasal deformities challenges all cleft surgeons. There is great variability of phenotypical anatomy, but iatrogenic changes and scarring from the previous surgeries add another layer of complexity. Rhinoplasties on a patient with cleft lip-palate are technically and intellectually challenging to master requiring a patient-tailored approach.

A preliminary report on the effect of gabapentin pretreatment on periprocedural pain during in-office posterior nasal nerve cryoablation.

Background: Posterior nasal nerve (PNN) cryoablation is a novel surgical technique to address allergic and nonallergic rhinitis. Periprocedural pain has been reported after PNN cryoablation and there are no standardized protocols for optimal in-office local anesthesia. This study sought to evaluate the effect of gabapentin on patient discomfort following in-office PNN cryoablation.

The anteromedial thigh free flap: a primary reconstructive option or second best?

Purpose Of Review: This article reviews the recent literature on the anteromedial thigh free flap.

Recent Findings: The anteromedial thigh (AMT) free flap is an excellent reconstructive option for head and neck defects. It is often overshadowed by the anterolateral thigh (ALT) free flap.

Transient Secondary Hypothyroidism and Thyroid Hormone Replacement Therapy in Pediatric Postoperative Cardiopulmonary Bypass.

Background: To develop an understanding of current practices in the management of transient secondary hypothyroidism in pediatric postoperative cardiopulmonary bypass (CPB) patients.

Methods: Electronic survey comprising a 10-item questionnaire was sent to sixty-four high volume pediatric heart centers in the United States and United Kingdom. Survey participants included cardiologists, intensivists, cardiothoracic surgeons, and advanced practice providers.

Regression of massive cardiac rhabdomyoma on everolimus therapy.

Cardiac rhabdomyoma is the primary feature of the genetic disease, tuberous sclerosis complex, the most common cardiac tumor diagnosed in neonates and infants. Spontaneous regression is observed in most cases, but these tumors may cause hemodynamic instability, arrhythmias or other complications. We describe the case of a critically ill neonate, resuscitated after cardiac arrest secondary to massive locally invasive cardiac rhabdomyoma, who was successfully treated with everolimus (mammalian target of rapamycin [mTOR] inhibitor).