April 2020 HSC Section 4 - Plastic and Reconstructive Problems

D. Facial paralysis Joseph AW, Kim JC. Management of flaccid facial paralysis of less than two years’ duration. Otolaryngol Clin North Am . 2018; 51(6):1093-1105. EBM level 4..............................................155-167 Summary : This article nicely outlines an algorithm for management of facial paralysis of less than 2 years’ duration. The authors refine an organized approach to treatment planning based on key clinical findings. Nellis JC, Ishii M, Byrne PJ, et al. Association among facial paralysis, depression, and quality of life in facial plastic surgery patients. JAMA Facial Plast Surg . 2017; 19(3):190-196. EBM level 2b.............................................................................................................................................168-174 Summary : This is a controlled prospective observational study looking at the correlation between depression, quality of life, and facial paralysis. Presence of facial paralysis as well as an increased severity of facial paralysis were found to correlate with a higher incidence of depression and lower quality of life when compared to controls. E. Facial fractures Dedhia RD, Morisada MV, Tollefson TT, Strong EB. Contemporary management of frontal sinus fractures. Curr Opin Otolaryngol Head Neck Surg . 2019; 27(4):253-260. EBM level 5.............175-182 Summary : Previously, treatment of mandible subcondylar fractures favored closed management. However, recent treatment trends suggest open reduction and fixation may provide better functional outcomes. This review of the topic additionally describes surgical technique. F. Septal perforation repair Ozturan O, Yenigun A, Senturk E, et al. Endoscopic endonasal repair of septal perforation with interpositional auricular cartilage grafting via a mucosal regeneration technique. Otolaryngol Head Neck Surg . 2016; 155(4):714-717. EBM level 4............................................................................187-190 Summary : The authors sought to demonstrate the efficacy of septal perforation repair closure by placing a interpositional auricular cartilage graft between septal mucosa without use of mucosal advancement flaps. Complete closure was achieved in > 80% of patients, and partial closure in > 15% of patients using this technique. All septal perforations were less than 20 mm. A. Craniofacial deformities Chen JT, Schmid DB, Israel JS, Siebert JW. A 26-year experience with microsurgical reconstruction of hemifacial atrophy and linear scleroderma. Plast Reconstr Surg . 2018; 142(5):1275-1283. EBM level 4...............................................................................................................................................191-199 Summary : The authors review their treatment strategy for facial reconstruction in patients with Parry Romberg syndrome. While the study has little objective data, in the authors’ experience, they have found free-tissue transfer provides greater longevity and may stabilize the disease process. Summary : Treatment of frontal sinus fractures has been evolving. Management may involve greater use of observation and minimally invasive procedures. Strohl AM, Kellman RM. Current management of subcondylar fractures of the mandible, including endoscopic repair. Facial Plast Surg Clin North Am . 2017; 25(4):577-580. EBM level 5..........183-186

III. CONGENITAL