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In This Issue of JAMA Facial Plastic Surgery
Nov/Dec 2017


JAMA Facial Plast Surg. 2017;19(6):447. doi:10.1001/jamafacial.2016.0615

Plawecki and colleagues examined the National Electronic Injury Surveillance System (a database of emergency department visits) from January 1, 2011, to December 31, 2015, for individuals 55 years or older who sustained facial fractures from recreational activities. They report 20 519 emergency department visits with the annual incidence of facial fractures from recreational activities increasing by 45.3% from 2011 through 2015. The authors found that bicycling and team sports were the most common activities involved, and men were more likely than women to sustain orbital and mandibular fractures.

Dey and colleagues sought to determine if differences were noted in how patients with facial paralysis perceive themselves compared with how casual observers and experts perceive them. This was conducted as a prospective cohort study of patients with permanent unilateral facial paralysis. Patients rated their paralysis severity, attractiveness, quality of life, and affect using established metrics. Casual observers and experts viewed standardized facial videos of each patient and then used the same metrics to rate each patient’s paralysis severity, attractiveness, quality of life, and affect. The authors found that casual observers and experts generally perceive patients with facial paralysis more negatively than patients perceive themselves.

Wilson and colleagues conducted a cadaveric study evaluating the warping of costal cartilage grafts using the oblique split method with an angle of 30° or the concentric carving method during a 3-month period. Millimeters of warp from baseline (at 1 hour) and at 1, 2, and 3 months were measured in the frontal and lateral planes. They found that these 2 methods were equivalent in terms of the amount of warp. The authors conclude that this new oblique split method may be superior because of easier carving and the increased volume of material with the same amount of warping compared with the standard concentric method of carving.

Continuing Medical Education

Insalaco and colleagues conducted a cadaveric study to determine the differences in the strength and resilience of the lateral crura after performing lateral crural overlay technique. The strength of 7 cadaveric lower lateral cartilages was measured with a force gauge prior to the lateral crural overlay procedure, after the procedure, and after the procedure with simulated fibrosis technique using glue. There was a statistically significant increase in lower lateral cartilage strength in the postprocedure with glue group compared with the other 2 groups at nearly all distances of deflection. The authors conclude that the lateral crural overlay technique strengthens the lower lateral cartilages and thus may prevent external nasal valve collapse.