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In This Issue of JAMA Facial Plastic Surgery
Nov/Dec 2016


JAMA Facial Plast Surg. 2016;18(6):407. doi:10.1001/jamafacial.2015.1242

Spataro and colleagues sought to estimate the 30-day hospital revisit rate following septorhinoplasty and the risk factors associated with revisits. A cohort of 175 842 patients who underwent septorhinoplasty from 2005 to 2009 were analyzed using data from the Healthcare Cost and Utilization Project state inpatient database, state ambulatory surgery database, and state emergency department database from California, Florida, and New York. The revisit rate was 6.5%, with the most common primary diagnosis being bleeding or epistaxis. Risks factors included older age, black race, and Medicare and Medicaid insured. Other associated clinical risk factors included diagnoses of autoimmune disorders or immunodeficiency, coagulopathy, or anxiety.

Loyo and coinvestigators conducted a retrospective case series of 34 patients who underwent placement of a modified butterfly graft to investigate if this updated surgical technique improved clinical outcomes (nasal airway improvement while decreasing graft visibility). Patient-reported measure of nasal patency improved with the surgical intervention. Three-quarters of the patients self-rated their appearance as improved or not changed compared with preoperatively, and on the basis of a masked outside observer survey of patient postoperative photographs, the butterfly graft was detected only 59.7% of the time (282 of 472 answers).

Hanba and colleagues characterize the incidence of facial fractures by patient demographics and injury mechanism, focusing on whether differences are noted with race, sex, and advancing age. They performed a retrospective analysis of the National Electronic Injury Surveillance System (NEISS), specifically evaluating adult emergency department visits from 2012 to 2014 related to facial trauma. They found that there was an increase in the risk of facial fracture among postmenopausal women sustaining facial injuries, particularly among whites and Asians. Black women did not have this increased fracture risk with advancing age.

Phillis and coinvestigators sought to measure the impact of surgically reconstructing facial lesions on observer-graded affect display. In this randomized survey of 120 naïve observers, faces with lesions prior to reconstructive facial surgery were statistically significantly more likely to be judged negatively than faces without lesions. However, there was no statistically significant difference between faces without lesions and faces with lesions that had undergone reconstructive facial surgery. Their findings support the importance of facial reconstructive surgery on patients' quality of life.

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