Impact of Resident and Attending Surgeon Training Level on Free Tissue Transfer Ischemia Time and Complications.

Background:  Microsurgical free tissue transfer has become an essential method for reconstruction of complex surgical defects, making the level of training an important factor to consider. There is little published regarding the impact of training level on microsurgical outcomes. This study investigates microsurgical free tissue transfer ischemia time and postoperative complications based on resident and attending surgeon experience level.

Craniosynostosis Associated With Novel TUBG1 Mutation (NM_001070.4:c.821C>T) (p.Thr274Ile).

TUBG1, a tubulin gene, plays an important role in neurodevelopment. Here we describe a case of a novel TUGB1 mutation (NM_001070.4:c.

Tumescent technique for split-thickness skin graft donor sites: A systematic review of randomized controlled trials.

Background: Split-thickness skin grafting (STSG) is widely used for reconstructive wound management. This review aimed to use level I evidence to determine if tumescent techniques were safe and effective compared to other interventions for STSG donor sites. It was hypothesized that tumescent techniques were safe and effective for STSG donor sites.

Aspirin-Exacerbated Respiratory Disease and the Unified Airway: A Contemporary Review.

Aspirin-exacerbated respiratory disease (AERD) is characterized by abnormal arachidonic acid metabolism leading to chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and upper and/or lower respiratory symptoms after ingestion of cyclooxygenase-1 inhibiting nonsteroidal antiinflammatory drugs. Diagnosis is clinical and may involve an aspirin challenge. Inflammatory biomarkers may be useful for diagnosis and treatment monitoring.

Improved Success Rate with Corticocancellous Block Compared to Cancellous-Only Trephine Technique in Alveolar Bone Grafting from the Iliac Crest.

Background: Alveolar bone grafting is an important component of cleft lip and palate treatment, with iliac crest as the most common donor site. Although studies have attempted to quantify alveolar bone graft resorption, few have directly compared the outcomes of graft techniques. This study compared the long-term success rates of corticocancellous block to trephine cancellous-only alveolar bone grafting from the iliac crest.

Squamous Cell Carcinoma Arising in Breast Implant Capsules.

Breast augmentation and reconstruction utilizing implants are among the most common plastic surgery procedures performed in the United States. A small proportion of these implants are removed each year. We report 2 cases where routine pathologic evaluation of capsulectomy specimens revealed squamous cell carcinoma associated with the breast implant capsule and discuss the possible pathogenesis of this unusual entity.

HPV-Related Multiphenotypic Sinonasal Carcinoma: A Case Report and Literature Review.

Objectives: Human papilloma virus-related multi phenotypic sinonasal carcinoma (HMSC), a recently characterized sinonasal malignancy, is discussed including histology, clinical presentation, and treatment outcomes.

Study Design: Case report with literature review.

Methods: A case of HMSC is reported, as well as a retrospective review of all cases of HMSC reported in the English literature from January 2000 through May 2018 in the MEDLINE, EMBASE, and Scopus databases.

Intraoperative Three-dimensional Virtual Reality and Computed Tomographic Guidance in Temporomandibular Joint Arthroplasty of Syndromic Craniofacial Dysostoses.

Bony ankylosis of the temporomandibular joints (TMJ) occurs in up to 28% of patients with syndromic mandibular dysostoses. Release of complete osseous ankylosis is particularly challenging due to the lack of tissue planes separating the mandible from the skull base and the presence of congenital skeletal abnormalities. One recent advance in surgical imaging technology is three-dimensional virtual reality (3D VR), now in common use in neurosurgical resections.

Intraoperative Image-Guided Navigation in Craniofacial Surgery: Review and Grading of the Current Literature.

Introduction: Image-guided navigation has existed for nearly 3 decades, but its adoption to craniofacial surgery has been slow. A systematic review of the literature was performed to assess the current status of navigation in craniofacial surgery.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) systematic review of the Medline and Web of Science databases was performed using a series of search terms related to Image-Guided Navigation and Craniofacial Surgery.

Middle turbinate manipulation and postoperative sinus obstruction after endoscopic endonasal skull-base surgery.

Background: Inadvertent lateralization of the middle turbinate (MT) after endoscopic sinus surgery (ESS) is cited as a common complication that results in both outflow tract obstruction and recurrent symptoms. In endoscopic endonasal skull-base surgery, the MT is frequently lateralized during the parasagittal approach. Little is known about whether this strategy has unintended consequences on the adjacent paranasal sinuses.

The association of air pollutants and allergic and nonallergic rhinitis in chronic rhinosinusitis.

Background: There has been little investigation regarding air quality and rhinitis in the pathophysiology of upper airway disease. In this study, we assessed the impact of inhalant pollutants (particulate matter 2.5 [PM ] and black carbon [BC]) on allergic rhinitis and chronic rhinosinusitis (CRS) disease severity.

Air pollutants may be environmental risk factors in chronic rhinosinusitis disease progression.

Background: Little is known about the role of environmental exposures in the pathophysiology of chronic rhinosinusitis (CRS). In this study, we measured the impact of air pollutants (particulate matter 2.5 [PM ] and black carbon [BC]) on CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP).

A Case Report and Systematic Review of Eosinophilic Angiocentric Fibrosis of the Paranasal Sinuses.

Objective: There is a paucity of literature discussing prognostic factors or comparing outcomes in eosinophilic angiocentric fibrosis (EAF). This review aims to analyze tumor and patient characteristics as possible prognostic markers and compare surgical approaches.

Methods: Systematic literature review and case report analyzing available cases of EAF located within the paranasal sinuses.

Monoclonal Antibodies for the Treatment of Nasal Polyps.

Biologics are novel therapeutic medications developed for the targeted therapy for a variety of inflammatory conditions. The biologics currently investigated for the treatment of chronic rhinosinusitis (CRS) with nasal polyps modulate specific inflammatory pathways involved in the pathogenesis of disease. Investigations have focused on the most severe form of the disease, namely, CRS with nasal polyps.

Anatomic Considerations for Sinonasal and Ventral Skull Base Malignancy.

Malignancies of the sinonasal region and ventral skull base include a varied group of uncommon tumors that are a challenge to treat. These malignancies, with few exceptions, often present late because of their insidious growth and bland symptomatology. As with malignancies of other sites, the primary goal in surgical management is complete resection with negative margins.

A systematic review of sinonasal oncocytomas and oncocytic carcinomas: Diagnosis, management, and technical considerations.

Background: Oncocytomas and oncocytic carcinomas are rare tumors of the sinonasal cavity with the propensity for local invasion. This report and systematic review details a case of a nasal oncocytoma involving the lacrimal sac and provides an update of the current literature.

Methods: A systematic literature review was performed using PubMed and Ovid databases.

Fabrication and validation of a low-cost, medium-fidelity silicone injection molded endoscopic sinus surgery simulation model.

Objectives/hypothesis: Develop a low-cost, medium-fidelity model for education in endoscopic sinus surgery techniques. Establish face and content validity of the model based on the feedback of otolaryngology faculty including fellowship-trained rhinologists.

Study Design: Survey.

Aberrant position of nonrecurrent inferior laryngeal nerve: Report of 3 cases and a review of the literature.

The presence of a nonrecurrent inferior laryngeal nerve (NRILN) is a significant risk factor for nerve injury during thyroid, parathyroid, and vascular surgeries involving the paratracheal area of the head and neck. The objective of this report is to review the association between an aberrant right subclavian artery (SCA) identified on preoperative imaging and an NRILN identified intraoperatively during thyroid and parathyroid surgery. We reviewed 3 selected cases in which we preoperatively identified an aberrant right SCA and determined the intraoperative position of the inferior laryngeal nerve on the right.

Quantifying Changes in Nasal Tip Support.

Importance: Imparting surgical change to the nasal tip remains one of the most challenging aspects of rhinoplasty. The surgeon must assess the tip preoperatively and execute the necessary maneuvers to impart the desired change.

Objective: To assess nasal tip resistance to compression in a cadaveric model before and after specific rhinoplasty maneuvers using a novel method.

Searching for Cedar: Geographic Variation in Single Aeroallergen Shows Dose Response in Internet Search Activity.

Objective: To assess the effect of a single aeroallergen on Internet search activity in 3 distinct geographic regions over time.

Study Design: A retrospective time series analysis.

Setting: Tertiary academic medical center.

Effect of environmental factors on Internet searches related to sinusitis.

Objectives/hypothesis: Sinusitis significantly affects the population of the United States, exacting direct cost and lost productivity. Patients are likely to search the Internet for information related to their health before seeking care by a healthcare professional. Utilizing data generated from these searches may serve as an epidemiologic surrogate.

Factors influencing 30-day emergency visits and readmissions after sleeve gastrectomy: results from a community bariatric center.

Introduction: Bariatric surgery has proven safe and effective for long-term weight loss in morbidly obese patients. Readmissions within 30 days of discharge have become an important metric for quality of care. Sleeve gastrectomy is a common bariatric procedure, but data regarding early readmission is sparse.