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Prabhat Bhama, MD, and colleagues propose a standardized approach to prospectively evaluate, manage, and follow patients with facial paralysis. The article presents an algorithm for surgical and adjunct interventions, recommends guidelines for intraoperative measurements, advocates facial expression poses during photographs, and suggests timing for outcome measurements. The authors emphasize that optimizing multi-institutional data collection improves the clinical care of patients with facial paralysis and advances outcomes research.
Author Video Interview
Kofi D. O. Boahene, MD, and colleagues use intraoperative electrical stimulation to measure the amplitude of the temporalis muscle tendon unit in patients undergoing correction for lower facial paralysis. The investigators quantify the available excursion of the muscle tendon unit after its release from the coronoid process and after its insertion at the modiolus. Their work highlights the importance of inserting the muscle tendon unit at the optimal tension to maximize outcomes.
Sami P. Moubayed, MD, and colleagues introduce their approach to assessing nasal tip position before and after surgical manipulation in fresh cadaveric specimens. The authors use an immobilized camera to obtain preoperative and postoperative photographs. Graphic editing software superimposes the photographs and measures changes in tip position. The study anatomically confirms previous clinical observations that the lateral crura steal technique increases rotation and projection.
Sachin S. Pawar, MD, and Tom D. Wang, MD, present a comprehensive review of secondary cleft nasal deformities. The authors discuss the clinical and anatomical features of cleft noses, repair strategies and timing of intervention, and surgical techniques. The article summarizes the outcomes literature on secondary cleft rhinoplasty.
Continuing Medical Education
Highlights. JAMA Facial Plast Surg. 2014;16(1):2. doi:10.1001/jamafacial.2013.2694