Manuela von Sneidern, Arman Saeedi, Audrey M Abend, Ethan Wiener, Silas W Smith, Danielle F Eytan
{"title":"Evaluation and Treatment of Acute Facial Palsy: Opportunities for Optimization at a Single Institution.","authors":"Manuela von Sneidern, Arman Saeedi, Audrey M Abend, Ethan Wiener, Silas W Smith, Danielle F Eytan","doi":"10.1089/fpsam.2024.0088","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0088","url":null,"abstract":"<p><p><b>Introduction:</b> Most patients with acute facial palsy initially present to emergency departments (EDs), where clinical practice guidelines (CPGs) recommend steroids, eye care, and follow-up with facial nerve specialists. <b>Objective:</b> To evaluate adherence to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Bell's palsy (BP) CPGs within EDs at a single academic institution. <b>Method</b>: We conducted a retrospective review of all patients diagnosed with acute facial palsy in the EDs of an academic tertiary care center between June 1, 2021, and June 1, 2022. <b>Results:</b> A total of 270 patients met inclusion criteria; most were male (<i>n</i> = 150, 55.9%), diagnosed with BP (<i>n</i> = 243, 90.0%), and presented to community-based emergency rooms (<i>n</i> = 170, 62.96). Although most patients received steroid treatment (<i>n</i> = 243, 90.0%), only 61.5% (<i>n</i> = 166) received the AAO-HNS-recommended course. Older patients and those who received steroids were more likely to receive imaging (<i>p</i> < 0.001<i>, p =</i> 0.03). Treatment with the AAO-HNS-recommended steroid regimen was associated with a higher likelihood of receiving laboratory evaluation (<i>p =</i> 0.02). Providers often advised follow-up; however, only 12.2% of patients were discharged with an electronic referral order. <b>Conclusion</b>: There are opportunities to standardize the treatment of patients in the ED presenting with acute facial palsy according to AAO-HNS CPGs.</p>","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary on Von Sneidern et al's \"Evaluation and Treatment of Acute Facial Palsy: Opportunities for Optimization at a Single Institution.\"-Bridging the Gap Between Guidelines and Practice.","authors":"Ciersten A Burks, Michael J Brenner","doi":"10.1089/fpsam.2024.0263","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0263","url":null,"abstract":"","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enrico Betti, Mariagrazia Paglianiti, Lisa Catarzi, Giuseppe Consorti
{"title":"Nonsurgical Rhinoplasty for Nasal Dorsum Correction: Patient Selection for Predictable Outcomes.","authors":"Enrico Betti, Mariagrazia Paglianiti, Lisa Catarzi, Giuseppe Consorti","doi":"10.1089/fpsam.2024.0033","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0033","url":null,"abstract":"","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabrina G Fabi, Stella Desyatnikova, Steven H Dayan
{"title":"Prevention and Management of Dermal Filler Complications: A Review.","authors":"Sabrina G Fabi, Stella Desyatnikova, Steven H Dayan","doi":"10.1089/fpsam.2024.0020","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0020","url":null,"abstract":"","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chenglong Wang, Dejin Gao, Pan Luo, Yue Wang, Qingguo Zhang
{"title":"A Cartilage-Saving Technique for Tragus and Antitragus Fabrication in Auricular Reconstruction.","authors":"Chenglong Wang, Dejin Gao, Pan Luo, Yue Wang, Qingguo Zhang","doi":"10.1089/fpsam.2024.0154","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0154","url":null,"abstract":"<p><p><b>Background:</b> For auricular reconstruction surgery using autologous costal cartilage, younger patients typically have a limited amount of costal cartilage available. <b>Objective:</b> We introduce a cartilage-saving technique for fabricating the tragus and antitragus, and evaluate its effectiveness based on aesthetic score and complications. <b>Methods:</b> For tragus fabrication, the residual part of the seventh costal cartilage was reoriented by 90° to increase its height and carved into a seagull-shaped structure. The antitragus was constructed by bending the antihelix and stabilizing it on the broadened base frame. Postoperative aesthetic outcomes and complications were documented and analyzed. <b>Results:</b> This study included a total of 658 patients with lobule-type microtia, of whom 356 (54.1%) were male and 302 (45.9%) were female. The average age was 6.5 ± 0.7 years, and the average follow-up period was 13.6 ± 3.5 months. The average aesthetic outcome score was 9.0 ± 0.7. Wound dehiscence at the tragus was seen in four patients, while circulation disturbance at the incisura intertragica area was noted in six patients. <b>Conclusions:</b> This cartilage-sparing technique demonstrated effectiveness in shaping aesthetic tragus and antitragus.</p>","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Skladman, David Chi, Gary B Skolnick, Alison K Snyder-Warwick
{"title":"Three Parameters Impact the Perception of Smile Asymmetry in Patients with Facial Paralysis.","authors":"Rachel Skladman, David Chi, Gary B Skolnick, Alison K Snyder-Warwick","doi":"10.1089/fpsam.2024.0177","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0177","url":null,"abstract":"<p><p><b>Background:</b> The ability to smile is impaired in patients with facial palsy, and objective parameters assessing smile symmetry to guide treatment are not well elucidated. <b>Objective:</b> This study seeks to identify objective facial measurements that relate smile recognition, perception of smile asymmetry, and perceived emotions from photographs of individuals with asymmetrical smiles compared with control photographs of individuals without smile asymmetry as measured by a photograph analysis application. <b>Methods:</b> Fifty-six photographs of smiles were categorized using objective perioral morphometric measurements (Emotrics). A photographic survey of these smiles was disseminated with queries regarding smile symmetry, smile recognition, and emotion perception. Generalized linear mixed modeling (GLMM) was performed to assess the effect of facial measurements on survey responses. <b>Results:</b> From 756 survey responses, smile symmetry predicted for smile recognition (F = 1084, <i>p</i> < 0.001) and emotion perception (F = 422, <i>p</i> < 0.001). Correlation analysis and GLMM identified three parameters (lower lip height, commissure position, and commissure height) that predicted smile recognition (F = 1040, <i>p</i> < 0.001), emotion perception (F = 976, <i>p</i> < 0.001), and symmetry (F = 1248, <i>p</i> < 0.001). Lower lip height (β = -57.84, <i>p</i> < 0.001) and commissure position (β = -29.41, <i>p</i> < 0.001) were the most significant drivers. <b>Conclusions:</b> Correcting lower lip height and commissure position represents efficacious clinical benchmarks for improving smile recognition by reducing smile asymmetry and conveying negative emotions.</p>","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tracy VandeWater, Kaitlynne Y Pak, Babak Azizzadeh
{"title":"Orbicularis Oculi Myectomy as an Adjunctive Procedure to Modified Selective Neurectomy for Postparalysis Facial Synkinesis: Technical and Safety Considerations.","authors":"Tracy VandeWater, Kaitlynne Y Pak, Babak Azizzadeh","doi":"10.1089/fpsam.2024.0269","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0269","url":null,"abstract":"","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"\"Invited Commentary: Three Smile Parameters Impact Smile Asymmetry Perception\" by Warwick et al.","authors":"Shai M Rozen","doi":"10.1089/fpsam.2024.0306","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0306","url":null,"abstract":"","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corin M Kinkhabwala, Allie Ottinger, Tanner Diemer, Krishna G Patel, Michelle S Hwang
{"title":"Effects of Chemodenervation on Ocular Synkinesis.","authors":"Corin M Kinkhabwala, Allie Ottinger, Tanner Diemer, Krishna G Patel, Michelle S Hwang","doi":"10.1089/fpsam.2024.0105","DOIUrl":"https://doi.org/10.1089/fpsam.2024.0105","url":null,"abstract":"<p><p><b>Background:</b> Chemodenervation is widely used for management of synkinesis in patients with facial palsy, but there is limited objective data assessing treatment effect. <b>Objective:</b> To measure the eyelid palpebral fissure height at rest and during movement after chemodenervation of the orbicularis oculi muscle among patients with ocular synkinesis, as measured on photographs with computerized facial analysis application. <b>Methods:</b> A retrospective review of patients who underwent initial chemodenervation to the orbicularis oculi for synkinesis was conducted from January 1, 2015, and July 26, 2023. Changes in palpebral height following injection \"at rest\" and during \"pucker\" (activation of ocular synkinesis) were calculated using the <i>Emotrics+</i> program. <b>Results:</b> Nineteen patients were identified: 78.9% female, 73.7% White, and a mean age of 49.74 ± 13.62yrs. They received a mean of 11.45 ± 3.57 units to the orbicularis oculi. A mean 37.63 ± 11.21 days elapsed between injection and postinjection photograph. Palpebral fissure height increased by a mean of 1.16 ± 1.86 mm while \"at rest\" (<i>p</i> = 0.014) and 2.31 ± 1.35 mm during \"pucker\" (<i>p</i> < 0.01). Injected dose was not associated with changes in palpebral fissure height \"at rest\" (<i>p</i> = 0.141) or during \"pucker\" (<i>p</i> = 0.125). <b>Conclusions:</b> Our findings suggest that chemodenervation of the orbicularis oculi improves palpebral fissure height in ocular synkinesis, more so during dynamic motion.</p>","PeriodicalId":48487,"journal":{"name":"Facial Plastic Surgery & Aesthetic Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}