Clinical and surgical factors associated with opioid refill rates following septorhinoplasty.

Background: Septorhinoplasty is one the most common class of procedures performed worldwide, and opioids are frequently prescribed for post-operative pain [1].

Objective: The objective of this study was to examine the rate of post-operative opioid prescription refills following septorhinoplasty.

Methods: This study was a case-control study of patients who underwent septoplasty and other secondary concomitant procedures.

Reconstruction of Large Composite Defects Extending Beyond the Nose.

Nasal reconstruction remains one of the most challenging surgeries for facial plastic and reconstructive surgeons. The addition of defects extending beyond the nose adds a layer of complexity to an already technically demanding surgery. This article will focus on the management of composite defects extending beyond the boundaries of the nose.

Outcome Comparison of Transconjunctival Müller's Muscle Recession With Levator Disinsertion (TMRLD) to Gold Weight Implantation in the Treatment of Paralytic Lagophthalmos.

Purpose: To compare clinical outcomes of transconjunctival Müller's muscle recession with levator disinsertion (TMRLD) to the traditional gold weight implantation in patients with paralytic lagophthalmos.

Methods: A retrospective nonrandomized comparative review of patients who had gold weight implantation and TMRLD surgeries for paralytic lagophthalmos from January 2016 to January 2023 was performed. The main outcome comparisons were measurement changes in lagophthalmos, marginal reflex distance 1, visual acuity, and corneal examination.

Preseptal transconjunctival approach in orbital floor fracture repairs to prevent postoperative lower eyelid malposition.

Purpose: Lower eyelid malposition can be a complication following orbital floor fracture surgeries. We present our incidence of lower eyelid malposition from a large case series of orbital floor fracture repairs using the 'swinging eyelid' approach and 'hang back' technique.

Methods: A retrospective review of all orbital fracture surgeries at our institution from November 2011 to March 2021 was performed.

Characteristics of Facial Trauma in Professional Mixed Martial Arts.

Injuries are common in mixed martial arts (MMA) competitions. However, the risk factors for facial injury have not been delineated. Identify the facial injuries and associated risk factors of professional MMA fights.

Telemedicine in Otolaryngology During COVID-19: An Exploratory Assessment of Provider and Patient Attitudes.

Objective: To determine provider and patient attitudes toward telemedicine in Otolaryngology-Head and Neck Surgery (OHNS).

Methods: Otolaryngology practitioners conducting outpatient clinics at an academic tertiary referral center were provided with a pre-Study Provider Perception Questionnaire (pre-PPQ) designed to evaluate pre-study perception of telemedicine in otolaryngology. A post-study Provider Perception Questionnaire (post-PPQ) designed to evaluate elements similar to those constituting the PrePPQ was completed at 6 weeks.

Aerosol and Droplet Generation from Open Rhinoplasty: Surgical Risk in the Pandemic Era.

The coronavirus disease 2019 pandemic has led to concerns over transmission risk from head and neck operations including facial cosmetic surgeries. To quantify droplet and aerosol generation from rhinoplasty techniques in a human anatomic specimen model using fluorescein staining and an optical particle sizer. Noses of human anatomic specimens were infiltrated using 0.

Wraparound nylon foil implant for isolated orbital floor fractures.

Purpose: There are a variety of implant materials available for orbital floor fracture repair. Implant selection is guided by surgeon experience, availability, and patient specific needs. The purpose of this study is to describe a "wraparound" technique for nylon foil implant placement for large, isolated floor fractures that provides excellent results with low incidence of enophthalmos or other complications.

Eyelid Coupling Using a Modified Tarsoconjunctival Flap in Facial Paralysis.

Eyelid coupling using the modified tarsoconjunctival flap is an effective treatment for paralytic ectropion. Eyelid position and quality of life can be improved in patients with flaccid facial paralysis using these eyelid coupling procedures. The modified tarsoconjunctival flap can obscure the lateral visual field by coupling the eyelids, but without distortion of the canthal angle and eyelid margin.

Aerosol and droplet generation from orbital repair: Surgical risk in the pandemic era.

Introduction: The highly contagious COVID-19 has resulted in millions of deaths worldwide. Physicians performing orbital procedures may be at increased risk of occupational exposure to the virus due to exposure to secretions. The goal of this study is to measure the droplet and aerosol production during repair of the inferior orbital rim and trial a smoke-evacuating electrocautery handpiece as a mitigation device.

Aerosol generation during routine rhinologic surgeries and in-office procedures.

Objective: Cadaveric simulations have shown endonasal drilling and cautery generate aerosols, which is a significant concern for otolaryngologists during the COVID-19 era. This study quantifies aerosol generation during routine rhinologic surgeries and in-office procedures in live patients.

Methods: Aerosols ranging from 0.

Ocular motility and diplopia measurements following orbital floor fracture repair.

Purpose: Diplopia and ocular motility restriction following orbital fracture repair are common complications. The reported rates in the literature differ greatly, in part due to varying definitions of diplopia and methods of measurement. The purpose of this study is to describe a practical and efficient in-office method for examining ocular motility and diplopia in orbital trauma patients and to report the outcomes in a series of patients who underwent orbital floor fracture repair.

Aerosol and droplet generation from mandible and midface fixation: Surgical risk in the pandemic era.

Purpose: The COVID-19 pandemic has led to concerns over transmission risk from healthcare procedures, especially when operating in the head and neck such as during surgical repair of facial fractures. This study aims to quantify aerosol and droplet generation from mandibular and midface open fixation and measure mitigation of airborne particles by a smoke evacuating electrocautery hand piece.

Materials And Methods: The soft tissue of the bilateral mandible and midface of two fresh frozen cadaveric specimens was infiltrated using a 0.

The association of weather, temperature, and holidays on pediatric maxillofacial trauma.

Objective: To evaluate the association of weather, seasons, months and holidays on the frequency and pattern of pediatric facial fractures.

Methods: Retrospective review of pediatric patients treated for facial fractures at two Level I trauma centers in a midsize Midwestern US city over a 5-year period. Patients were included only if presentation was within 3 hours of inciting trauma, transfers from other facilities were excluded.

Mitigation of Aerosols Generated During Rhinologic Surgery: A Pandemic-Era Cadaveric Simulation.

Objective: After significant restrictions initially due to the COVID-19 pandemic, otolaryngologists have begun resuming normal clinical practice. However, the risk of SARS-CoV-2 transmission to health care workers through aerosolization and airborne transmission during rhinologic surgery remains incompletely characterized. The objective of this study was to quantify the number concentrations of aerosols generated during rhinologic surgery with and without interventions involving 3 passive suction devices.

Reverse-Surge Planning During the COVID-19 Pandemic: A Cautionary Ramp-up for the Otolaryngologist.

As the coronavirus disease 2019 (COVID-19) pandemic continues to evolve through the United States and other countries, differing rates of progression and decline are occurring based on varied population densities. While some health systems are reaching a steady state of new patient cases, others are seeing a leveling off or decline, allowing for restoration of normal practices. This "reverse-surge" planning and implementation process is a colossal undertaking for health systems trying to reacquire patient access and financial stability while preserving necessary resources and maintaining precautions for another potential surge.

Facial nerve repair utilizing intraoperative repair strategies.

Objectives: To determine whether functional and anatomical outcomes following suture neurorrhaphy are improved by the addition of electrical stimulation with or without the addition of polyethylene glycol (PEG).

Methods: In a rat model of facial nerve injury, complete facial nerve transection and repair was performed via (a) suture neurorrhaphy alone, (b) neurorrhaphy with the addition of brief (30 minutes) intraoperative electrical stimulation, or (c) neurorrhaphy with the addition electrical stimulation and PEG. Functional recovery was assessed weekly for 16 weeks.

Impact of the COVID-19 Global Pandemic on the Otolaryngology Fellowship Application Process.

On March 11, 2020, the World Health Organization declared coronavirus disease 2019 a global pandemic. In addition to massive social disruption, this pandemic affected the traditional fellowship interview season for otolaryngology subspecialties, including head and neck surgical oncology, facial plastic and reconstructive surgery, laryngology, rhinology, neurotology, and pediatric otolaryngology. The impact on the fellowship interview process, from the standpoint of the institution and the applicant, necessitated the use of alternative interview processes.

Hair-bearing human skin generated entirely from pluripotent stem cells.

The skin is a multilayered organ, equipped with appendages (that is, follicles and glands), that is critical for regulating body temperature and the retention of bodily fluids, guarding against external stresses and mediating the sensation of touch and pain. Reconstructing appendage-bearing skin in cultures and in bioengineered grafts is a biomedical challenge that has yet to be met. Here we report an organoid culture system that generates complex skin from human pluripotent stem cells.

Readability of Printed Online Education Materials on Pituitary Tumors: Untangling a Web of Complexity.

Background: Patients are increasingly turning to the internet for health education. Due to the complex pathophysiology, clinic-diagnostic profile, and management spectrum of pituitary tumors, an evaluation of the readability of printed online education materials (POEMs) regarding this entity is warranted.

Objective: (1) To apply established readability assessment tools to internet search results on the topic of pituitary tumors.

Telehealth Opportunities for the Otolaryngologist: A Silver Lining During the COVID-19 Pandemic.

The utilization of telemedicine has seen a relatively slow progression over the past 50 years in the US health care system. Technological challenges limiting the ease of use of robust video platforms have been a major factor. Additionally, the perception by many health care providers that telehealth is reserved for only the rural population or that it provides limited value due to the inability to perform in-depth physical examinations contributes to the slow adoption.

Cadaveric Simulation of Endoscopic Endonasal Procedures: Analysis of Droplet Splatter Patterns During the COVID-19 Pandemic.

Objective: The primary mode of viral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is thought to occur through the spread of respiratory droplets. The objective of this study was to investigate droplet and splatter patterns resulting from common endoscopic endonasal procedures.

Study Design: Cadaver simulation series.