Effects of COVID-19 on Facial Plastic and Reconstructive Surgery Fellowship Training and Director Practices.

Objectives: The objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training.

Study Design: Cross-sectional survey.

Setting: Online.

Quality of Life Outcomes After Modified Selective Neurectomy for Postfacial Paralysis Synkinesis.

Until now, quality of life (QOL) outcomes after modified selective neurectomy for postfacial paralysis synkinesis (PFPS) have not been assessed. To evaluate QOL outcomes among patients with PFPS who underwent modified selective neurectomy. The medical records of patients aged ≥18 years with PFPS who underwent modified selective neurectomy during a 6-year period were reviewed.

Otolaryngology Applicant Characteristics and Trends: Comparing OTO-HNS with Peer Specialties.

Purpose: To evaluate the recent Otolaryngology-Head and Neck Surgery (OTO-HNS) applicant characteristics, to identify which applicant characteristics are associated with successful match into OTO-HNS, and to compare OTO-HNS applicant trends and characteristics to that of peer surgical specialties (PS).

Materials And Methods: Data were obtained from official reports by the National Residency Matching Program (NRMP) for OTO-HNS, plastic and reconstructive surgery, orthopedic surgery, neurosurgery, and dermatology from 2006 to 2019. Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination (USMLE) scores, research productivity, graduation from a top-40 NIH-funded U.

Modern Management of Facial Nerve Disorders.

Facial paralysis is a devastating condition, encompassing a spectrum of disorders, with resultant psychosocial, functional, and aesthetic sequelae. With this in mind, an individualized treatment approach based on the cause, pattern, and duration of palsy is necessary. Treatment options include pharmacologic agents, corneal protective interventions, physical therapy, and surgical procedures.

Synkinetic Unilateral Lower Lip Palsy: Diagnosis and Technical Considerations for Facial Reanimation.

There are no universally adopted surgical techniques to treat depressor labii inferioris (DLI) dysfunction in patients with postfacial paralysis synkinesis. We describe a novel description of this disorder and technical surgical considerations for reanimation. To describe a new classification for DLI dysfunction and a surgical option to restore a natural appearing full dentition smile.

Correction of the Overly Shortened Nose.

The overly shortened nose can often be the result of previous rhinoplasty. The causes can include weakening or missing cartilage for nasal tip support as well as contraction and scarring of the skin. The purpose of this article was to provide the authors' approach to this deformity.

Facial nerve management in patients with malignant skull base tumors.

Introduction: The course of the facial nerve through the cerebellopontine angle, temporal bone, and parotid gland puts the nerve at risk in cases of malignancy. In contrast to Bell's palsy, which presents with acute facial paralysis, malignancies cause gradual or fluctuating weakness.

Methods: We review malignancies affecting the facial nerve, including those involving the temporal bone, parotid gland, and cerebellopontine angle, in addition to metastatic disease.

Ideas and Innovations to Improve the Otolaryngology-Head and Neck Surgery Residency Application and Selection Process.

Objective: To (1) summarize strategies proposed in the recent otolaryngology-head and neck surgery (OTO-HNS) literature for improving the residency application and selection process, (2) evaluate the effects of recently implemented changes to the OTO-HNS match, and (3) discuss recommendations for future changes to the OTO-HNS residency application and selection process.

Data Sources: PubMed, Medline Ovid database, and article reference lists.

Review Methods: A structured literature search was performed to identify current English language articles relating to the objectives of this study using the aforementioned data sources, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines.

Outcomes of a Treatment Protocol for Compromised Nasal Skin in Primary and Revision Open Rhinoplasty.

This is the first study to review the incidence of nasal skin compromise after open rhinoplasty surgery and outcomes of treatment. To determine whether risk of skin compromise after open rhinoplasty surgery can be predicted and whether our treatment protocol led to acceptable outcomes. This is a retrospective chart review of the senior author's private patients.

Telemedicine Practices of Facial Plastic and Reconstructive Surgeons in the United States: The Effect of Novel Coronavirus-19.

The objectives of this study among facial plastic and reconstructive surgeons (FPRS), include (1) quantifying the use of telemedicine, (2) examining the impact of novel coronavirus-19 (COVID-19) on telemedicine practices, (3) highlighting the types of telemedicine employed, (4) anticipating how telemedicine will be utilized in the future, and (5) describing FPRS' attitudes and understanding of telemedicine technologies. Cross-sectional survey. A 6-13 question survey was sent to the American Academy of Facial Plastic and Reconstructive Surgery membership.

The Potential for Telemedicine to Reduce Bias in Patients Seeking Facial Plastic Surgery.

Telemedicine use among otolaryngologists-head and neck surgeons and facial plastic and reconstructive surgeons has accelerated as a result of the COVID-19 pandemic. Yet, it is unclear what impact the increased adoption of telehealth will have on the doctor-patient relationship, patients' perceptions of individual practices, and the likelihood of patients proceeding with the next steps toward surgery. While an understanding of these complex questions is imperative for all otolaryngologists, it is extremely important for facial plastic surgeons who focus on elective procedures, particularly cosmetic/aesthetic operations.

Pass/Fail Scoring of USMLE Step 1 and the Need for Residency Selection Reform.

The Federation of State Medical Boards and the National Board of Medical Examiners recently announced a change in the United States Medical Licensing Examination Step 1 scoring convention to take effect, at the earliest, on January 1, 2022. There are many reasons for this change, including decreasing medical student stress and incentivizing students to learn freely without solely focusing on Step 1 performance. The question remains how this will affect the future of the otolaryngology-head and neck surgery match.

A Guide to Developing Safety Protocols for International Craniofacial Outreach Programs During the COVID-19 Era.

The ongoing COVID-19 outbreak has created obstacles to health care delivery on a global scale. Low- and middle-income countries (LMICs), many of which already suffered from unmet surgical and medical needs, are at great risk of suffering poor health outcomes due to health care access troubles brought on by the pandemic. Craniofacial outreach programs (CFOP)-a staple for craniofacial surgeons-have historically provided essential care to LMICs.

Subunit Approach to Facelifting and Facial Rejuvenation.

Facial analysis techniques traditionally separate the upper, middle, and lower facial thirds as distinct entities without guidance in achieving aesthetic youthfulness. There is now an opportunity to develop better analytical tools and specific algorithms to help create an overall harmony to the face and restore a youthful appearance. Facial anatomic subunits have similar three-dimensional qualities based on underlying anatomic structures, craniofacial skeletal modeling, superficial and deep facial fat compartments, skin thickness, facial muscle activity, and curvature (flat, convex, concave).

Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology.

Objective: To (1) review concepts of medical hierarchy; (2) examine the role of medical hierarchy in medical education and resident training; (3) discuss potential negative impacts of dysfunctional hierarchy in medical and surgical training programs, focusing on otolaryngology; and (4) investigate solutions to these issues.

Data Sources: Ovid Medline, Embase, GoogleScholar, JSTOR, Google, and article reference lists.

Review Methods: A literature search was performed to identify articles relating to the objectives of the study using the aforementioned data sources, with subsequent exclusion of articles believed to be outside the scope of the current work.

Facial Fractures and the National Basketball Association: Epidemiology and Outcomes.

Objectives/hypothesis: To identify the epidemiology and impact of facial fractures on player performance and return to play (RTP) in the National Basketball Association (NBA).

Study Design: Retrospective case-control series METHODS: Fifty-three NBA players who sustained facial fractures between 1984 and 2018 were identified. Players with pre- and postinjury statistics were included in the performance analysis.

Modified Selective Neurectomy with Symmetrical Facial Repositioning.

There are no surgical techniques described to treat synkinesis and concurrent facial asymmetry. We describe our innovative and effective approach and technique. To improve the spontaneous smile mechanism as well as facial symmetry in patients with synkinesis not only during the smile mechanism but also at rest.

Single-incision sural nerve harvest: Technical considerations for cross-facial nerve grafting.

b.a. is the senior author and performed all of the procedures described, and conceptualized and edited the article.

Modified Selective Neurectomy for the Treatment of Post-Facial Paralysis Synkinesis.

Background: To address functional and smile dysfunction associated with post-facial paralysis synkinesis, the senior author (B.A.) has offered "modified selective neurectomy" of the lower division of the facial nerve as a long-term solution.

The role of the otolaryngologist in the evaluation and management of headaches.

Background: Headaches are commonly evaluated in otolaryngology and often represent a diagnostic dilemma. This review addresses rhinogenic headache as well as trigeminal neuralgia and migraine, both of which can masquerade as sinus headache and whose management increasingly involves otolaryngology intervention. Discussion considers diagnostic criteria and novel therapies and derives an algorithm for clinical decision-making.

Surgical Management of Postparalysis Facial Palsy and Synkinesis.

Modified selective neurectomy of the distal branches of the buccal, zygomatic, and cervical branches of the facial nerve in addition to platysmal myotomy is an effective surgical procedure for the treatment of postfacial paralysis synkinesis. Success of this procedure depends on identification of the peripheral facial nerve branches, preservation of zygomatic and marginal mandibular branches that innervate key smile muscles, and ablation of buccal and cervical branches that cause lateral and/or inferior excursion of the oral commissure. Results are long-lasting; objective improvements in electronic clinician-graded facial function scale score, House-Brackmann score, and decreased botulinum toxin-A requirements have been observed.

Current Trends in Upper and Lower Eyelid Blepharoplasty Among American Society of Ophthalmic Plastic and Reconstructive Surgery Members.

Purpose: To assess current practice patterns for management of upper and lower eyelid blepharoplasty by active American Society of Ophthalmic Plastic and Reconstructive Surgery members.

Methods: An invitation to participate in a web-based anonymous survey was sent to the active American Society of Ophthalmic Plastic and Reconstructive Surgery membership via email. The survey consists of 34 questions, both multiple choice and free response, regarding upper and lower eyelid blepharoplasty surgery.