BACKGROUND:Blepharoplasty treats dermatochalasis. Surgical modifications in blepharoplasty for East Asians exist. However, studies that compare the intraoperative design and outcomes between East Asian and Northern European patients are limited. PURPOSE:The purpose of this study is to compare the intraoperative ocular soft tissue designs including lid crease position (LCP, measured from upper eyelid crease to the lid margin), the width of the skin resected, and the postsurgical outcomes between the 2 groups. STUDY DESIGN, SETTING, SAMPLE:This is a retrospective cohort study of East Asian and Northern European patients with diagnosis of dermatochalasis, who underwent blepharoplasty at Emory University Hospital between 2011 and 2021. Patients with ptosis or prior surgeries were excluded. PREDICTOR VARIABLE:The predictor variable is race (Northern European or East Asian). OUTCOME VARIABLES:The main outcome variable was intraoperative soft tissue design measured using LCP and the width of the skin resected. The secondary outcome variable was the postoperative change in the amount of blepharoptosis measured by changes in margin reflex distance (MRD-1). COVARIATES:Covariant is gender (self-defined male or female). ANALYSES:A t-test was conducted. P < .05 was statistically significant. RESULTS:The sample was composed of 642 subjects with a mean age of 66.8 (SD = 9.1), 195 (30.4%) were male, and 54 (8.4%) were East Asian. The LCP was 6.7 mm (SD = 1.6) for the East Asians and 9.9 mm (SD = 0.5) for the Northern Europeans (P < .05). The width of the skin excised was 4.2 mm (SD = 1.6) for the East Asians and 8.7 mm (SD = 2.0) for the Northern European (P < .05). The MRD-1 change was 1.5 ± 1.1 mm in the East Asians and 1.1 ± 1.1 mm in Northern Europeans (P < .05). CONCLUSIONS AND RELEVANCE:East Asians have different eyelid anatomy; thus, the blepharoplasty design is adjusted to preserve their ethnic natural appearance. This study found that the East Asian group had less LCP, smaller width of the skin excised, and a greater improvement in the MRD-1. This information could be useful for the intraoperative design of East Asian eyelids.

BACKGROUND:Professionalism is one of the core competencies required by the Commission on Dental Accreditation (CODA). The purpose of this study was to determine if publication inaccuracies exist among applicants OMS residency programs. MATERIALS AND METHODS:Retrospective cohort observational study of OMS applications to the Emory University oral and maxillofacial surgery program from 2017 to 2020. Information was obtained from the ADEA PASS application portal. The primary predictor variable was the sum of peer-reviewed publications reported by each applicant. The primary outcome variable was the presence of an inaccuracy in an application and the secondary outcome variable was the severity of inaccuracy (major or minor) according to previously reported method. Major inaccuracies consist of misrepresentation of publication authorship, verifiability, peer-review status, or journal citation. Minor inaccuracies are incorrect author order or citation errors (e.g. title misspellings). RESULTS:Of the applications sent, 578 applications met the inclusion criteria. One in twelve applicants was found to have at least one inaccuracy in their application. Applicants who reported more than two peer-reviewed publications or included at least one non-peer-reviewed publication were more likely to have a publication inaccuracy (p < 0.001 and p = 0.011, respectively). CONCLUSION:Our preliminary data demonstrates publication inaccuracies occur among OMS applicants. There may be an increased association between applicants who report more than one peer-reviewed article and inaccuracies. With this data, OMS programs may consider checking details of applicants who report more publications than their peers.

Current treatments for congenital and acquired craniofacial (CF) bone abnormalities are limited and costly. Conventional methods involve surgical correction, short-term stabilization, and long-term bone grafting, which may include problematic allografts and limited autografts. While bone morphogenetic protein 2 (BMP2) has been used for bone regeneration, it can cause bone overgrowth and life-threatening inflammation. Bone marrow-derived mesenchymal stem cell therapies, though promising, are not Food and Drug Administration approved and are resource intensive. Thus, there is a need for effective, affordable, and less side-effect-prone bone regenerative therapies. Previous research demonstrated that JAGGED1 induces osteoblast commitment in murine cranial neural crest cells through a NOTCH-dependent non-canonical pathway involving JAK2–STAT5. We hypothesize that delivery of JAGGED1 and induction of its downstream NOTCH non-canonical signaling in pediatric human osteoblasts constitutes an effective bone regenerative treatment. Delivering pediatric human bone-derived osteoblast-like cells to an in vivo murine bone loss model of a critically sized cranial defect, we identified that JAGGED1 promotes human pediatric osteoblast commitment and bone formation through p70 S6K phosphorylation. This approach highlights the potential of JAGGED1 and its downstream activators as innovative treatments for pediatric CF bone loss.

Coronavirus disease 2019 (COVID- 19) affected daily activities since December 2019. Burn injuries to head and neck can result in cosmetic and functional deformities. The purpose of this study was to characterize patients with burns to head and neck during the pandemic. This cross-sectional study reviewed patients in Burn Care Quality Platform Registry. Patients were included if they were age 18 years of age or older, and sustained burns to head and neck. Patients were stratified according to date of injury into: (1) March 13 to September 13, 2019 (i.e., before COVID-19 pandemic, BC19) or (2) March 13 to September 13, 2020. March 13, 2020 was chosen because (1) COVID-19 was announced as a national emergency on that date and (2) it was the last day of in-person schools in state of Georgia. Data collection included patient demographics, admission details, burn details, and hospital related variables were documented. During the study period, 157 patients had burn to head and neck (BC-19; 70, C-19; 71). Our data showed a 375% increase in March following the announcement of the pandemic (BC19; 4, C19;19). Admissions from another facility were statistically more than in C19 group (p=<0.0001). For C19 group, there were 53% more admissions from ED than BC19 (p=0.001). Additionally, in BC19 group patients presented with concomitant inhalation injuries significantly more than C19 group (p=0.04). In conclusion, the total number of burns is the same during BC and C19, however there was a significant spike in number of cases in March 2020.

Antibiotic prophylaxis is the use of antibiotics perioperatively to prevent infections at the surgical site or distant locations. The decision to provide prophylaxis must balance risks of antibiotic resistance, adverse drug reactions, and increased health care costs with the benefit of decreasing infection. This determination has been studied extensively in patients with specific cardiac conditions and prosthetic joints. Prophylactic antibiotics in healthy patients have been shown to reduce the frequency of alveolar osteitis and decrease the failure rates of dental implants.

BACKGROUND:One-way alphanumeric pagers remain a primary communication method for health care providers, despite the rise of app-based communication systems. Frequent nonurgent pages can disrupt workflows and potentially impact patient care, particularly in high-demand specialties like oral and maxillofacial surgery (OMS). PURPOSE:The purpose of this study was to examine the association between paging patterns and time of day among OMS residents. STUDY DESIGN, SETTING, SAMPLE:This retrospective cohort study analyzed paging data from the Emory Healthcare OMS service in 2021 and 2022. Pages included were those received by primary OMS residents responsible for inpatient care, consultations, and emergency department evaluations. Exclusions were pages related to outpatient matters and those sent to backup or senior-level residents. PREDICTOR VARIABLE:The primary predictor variable was paging rate, defined as the number of pages received per hour. This measure captures the intensity of paging activity during specific periods. MAIN OUTCOME VARIABLE:The primary outcome variable was time of day, categorized into peak and off-peak hours. Peak hours were statistically determined through data analysis and were defined as 07:00-20:00 on weekdays and 09:00-14:00 on weekends. Off-peak hours included all other time periods. Secondary outcomes included the comparison of paging rates on weekdays versus weekends to identify potential variations in paging activity. COVARIATES:There are no covariates. ANALYSIS:An independent t test was used to compare paging rates between peak and off-peak hours and between weekdays and weekends. Two-sided P values < .5 were considered statistically significant. RESULTS:There were 7,224 pages. Of them, 4,626 pages met the inclusion criteria. In 2021, there was an average of 18.8 pages per day (range: 0 to 56; standard deviation: 10.2). In 2022, there were 19.2 pages per day (range: 3 to 52; standard deviation: 8.7). Weekdays had more pages (20.8 pages/day) than weekends (14.3 pages/day; P < .001). During weekday peak hours, there were 1.3 pages/hour compared to 0.4 pages/hour during off peak hours (P < .001). During weekend peak hours, there were 0.9 pages/hour compared to 0.5 pages/hour during off-peak hours (P value < .001). Weekdays between 0700 and 0800 had the highest average number of pages (1.53 pages/hour). CONCLUSION AND RELEVANCE:This study identified patterns in paging rates, with significantly higher paging activity during peak hours and on weekdays. Awareness of these patterns may inform the development of protocols to minimize nonurgent interruptions during critical times, such as during patient handoffs.

BACKGROUND:Matching into Oral and Maxillofacial Surgery (OMS) residency in the United States (US) is competitive. Various surgical and medical specialties found that a relationship exists between the geographic location where an applicant attends medical school and the location where they attend residency. However, information regarding this geographic relationship does not exist in OMS. PURPOSE:The purpose of this study was to investigate if a relationship exists between the location of an applicant's dental school and the location of the OMS program where they match for residency. STUDY DESIGN, SETTING, SAMPLE:Study team conducted a cross-sectional review of all civilian OMS applicants who participated in the Postdoctoral OMS Matching Program from 2012 to 2022. US States and the District of Columbia were subdivided into a specific Region and Division as defined by the US Census Bureau. PREDICTOR VARIABLE:The primary predictor variable was the geographic location of the applicant's dental school. MAIN OUTCOME VARIABLE:The outcome variable was the geographic location where the applicant matched for residency. COVARIATES:There were no covariates analyzed in the study. ANALYSES:Frequency tables were created for the expected and observed values for each possible combination of dental school and residency location. MATLAB R2023a software was used for statistical analysis. χ2 test, odds ratio and confidence interval were calculated to investigate association between variables. P values were <.05. RESULTS:1768 applicants were reviewed. The inclusion criteria consisted of civilian OMS applicants from 2012 to 2022 who matched into residency. Of the 968 applicants who met the inclusion criteria, 48.45% (469/968, P -value < .001) matched into a residency in the same US Region as their dental school; 36.26% (351/968, P value < .001) matched into the same US Division. Applicants were found to be significantly more likely to match into a program in the same US Region and Division as their dental school. CONCLUSION AND RELEVANCE:It is likely that individuals will match into OMS residency in the same US Region and Division as their dental school. This information helps applicants and residency programs during the match process.

BACKGROUND:The impact of cleft and craniomaxillofacial (CCMF) surgeons on oral and maxillofacial surgery (OMS) resident training is not well known. PURPOSE:The purpose of this study was to measure the association between resident exposure to OMS faculty with CCMF surgery training, clinical experience, and scholarly activity. STUDY DESIGN, SETTING, SAMPLE:An anonymous survey of OMS residency directors in the United States, distributed electronically by the American Association of Oral and Maxillofacial Surgeons, was used to conduct a cross-sectional study. Survey consisted of 3 following sections: 1) CCMF surgery faculty and program-related information, 2) CCMF surgery curriculum in residency programs, and 3) academic productivity related to CCMF surgery. PREDICTOR VARIABLE:Primary predictor variable was CCMF surgery exposure: presence or absence of an OMS faculty with CCMF surgery fellowship or equivalent. MAIN OUTCOME VARIABLE:Primary outcome variables were: 1) number of CCMF surgery cases with OMS resident involvement, 2) number of OMS residents who pursued CCMF surgery fellowship, and 3) CCMF-related academic productivity of faculty and residents by abstract or publication. COVARIATES:Covariates include clinical experience of OMS residents in CCMF surgery cases and CCMF surgery-related academic productivity. ANALYSES:Descriptive statistics and continuous/ordinal variables were summarized. Fisher exact and Wilcoxon Rank Sum tests were completed. 2-sided P values of <.05 were considered statistically significant. RESULTS:There were 81 completed surveys (91% response rate; excluded military programs). Almost half of OMS training programs have at least one attending surgeon who completed a CCMF surgery fellowship (n = 36/81, 44.4%). OMS departments with a CCMF surgery-trained faculty performed more operations on patients with congenital craniofacial differences (P value <.001) and were more likely to publish at least one manuscript related to CCMF surgery in the last 5 years (P value = .029). CONCLUSION AND RELEVANCE:Nearly half of OMS training programs have at least one attending surgeon who completed a CCMF surgery fellowship or equivalent. CCMF surgery faculty may increase opportunities for OMS resident involvement in caring for patients with congenital craniofacial differences. There is academic productivity in programs with CCMF surgeons. This should improve as the cohort of CCMF trained oral and maxillofacial surgeons increases.

BACKGROUND:Sports injuries account for 11.3 to 42.1% of the facial fractures. Injuries from contact with a ball, a bat or stick, or another player raise safety concerns. PURPOSE:The purpose of this study was to assess the patterns of sports-related maxillofacial injuries involving orbital bone fractures in children. STUDY DESIGN, SETTING, AND SAMPLE:This was a retrospective case series of children who presented to Children's Healthcare of Atlanta from 2015 to 2021, with orbital injuries resulting from sports. INDEPENDENT VARIABLE:None. OUTCOME VARIABLE:The outcome variables, including the fracture location, pattern, and the management of injury. COVARIATES:The medical record were reviewed for the following variables: 1) demographic information, 2) mechanism of injury, 3) type of sport, 4) symptoms, 5) length of inpatient stay, and 6) duration of follow-up. ANALYSIS:Data were collected using a standardized collection form. Descriptive statistics were calculated. RESULTS:Overall, 101 patients (92 males) with an age of 13 ± 3 met the inclusion criteria. The most common sport was baseball or softball (n = 78, 77.2%). The mechanisms of injuries were largely due to collision with the ball (n = 79, 78.2%) or with another player (n = 13, 12.9%). Orbital fractures occurred mostly in the floor (n = 87, 86.1%), followed by the medial wall (n = 22, 21.8%), with an average of 1 surface involved. Maxillary sinus (n = 23, 22.8%) and/or nasal bone (n = 17, 16.8%) were the other facial bones outside of orbit commonly injured. The fractures patterns are minimally/nondisplaced (n = 68, 67.3%), displaced (n = 30, 29.7%), or comminuted (n = 3, 3%). The managements include surgical and nonsurgical. Twenty-three patients (22.8%) underwent surgical intervention. Twelve of them had an emergent operation due to extraocular muscle entrapment. CONCLUSION:Sports injuries are a common cause of orbital trauma in children. Most injuries are due to baseball/softball from collision with the ball. They were mostly managed without surgery, except for the individuals that presented with entrapment, oculocardiac reflex, and a large-size defect. The information from this project could be utilized in implementing safety equipment use for participants to further prevent such injuries.

Cleft and craniofacial surgery is a specialty with a long history involving oral and maxillofacial surgery (OMS). The number of pediatric cleft and craniofacial surgery fellowships increased during the last 10 years. However, information regarding the demand for surgeons with this advanced training is scant. The purpose of this study was to describe current practice of graduates of OMS fellowship programs.

Introduction: The purpose of the study was to provide an overview of our initial experience utilizing urinary bladder matrix (UBM) for reconstructing avulsed injuries resulting from trauma. Materials and Methods: This retrospective case series evaluated patients presented with avulsed soft tissue injuries to the head and neck who underwent reconstruction with UBM. Patients were treated by Oral and Maxillofacial Surgery Service in Louisiana State University Health Sciences Center (Baton Rouge, LA). Descriptive variables were collected. Descriptive statistics were calculated. Results: Eight patients (mean age 55.8 y) met our inclusion criteria. Wounds were located in the scalp (n=2, 25%), mandible (n=2, 25%), upper eyelid (n=1, 12.5%), cheek (n=1, 12.5%), nose (n=1, 12.5%), or neck (n=1, 12.5%). The depth of the wound extended from the skin to the subcutaneous tissue (n=1, 12.5%), muscle (n=2, 25%), bone (n=3, 37.5%), and/or cartilage (n=1, 12.5%). The mean wound diameter was 47.9 cm 2 (range 17–85 cm 2 ). Wounds were classified as acute (n=6, 75%) or chronic wounds (n=2, 25%). At 6 months, all patients had achieved complete healing with no need for additional surgical procedures (n=8, 100%) with a mean healing time of 36.5 days (range 14–90 d). Conclusion: Urinary bladder matrix minimize donor-side morbidity, eliminates contraction, and offers a wide range of product sizes to cover a wide range of maxillofacial soft tissue defects in a single-stage manner.