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Rhinoplasty is one of the most popular operations in the world. Despite its popularity, rhinoplasty complications are common and stem from a myriad of issues both subjective and objective in nature. Complications of rhinoplasty include scar, asymmetries, irregularities, imperfections, nasal airway obstruction, skin ischemia or necrosis, nasal collapse, nasal deformity, and overcorrection or undercorrection of a perceived nasal irregularity. A thorough understanding of these potential complications, along with strategies for avoidance and management, is critical for ensuring patient safety and optimizing surgical outcomes.

Understanding rhinoplasty characteristics important to patients, physicians, and society is essential for evaluating outcomes and designing optimal treatment plans. The authors aimed to elucidate specific rhinoplasty-related outcomes that are most important to patients, surgeons, and the general population. A cross-sectional survey comprising 11 rhinoplasty-specific characteristics, was distributed to patients, facial plastic surgeons, and the general population. Adult patients presenting for rhinoplasty consideration or follow-up after undergoing rhinoplasty were recruited. Characteristics rankings were compared between the 3 respondent groups using Spearman’s rank correlation coefficient (ρ). Responses from 150 surgeons, 111 patients, and 102 lay individuals from the general population were included for analysis. When ranking rhinoplasty-specific characteristics in order of importance, patients and the general population ranked “ability to breathe through nose while awake” first and “overall appearance of nose” as second. Surgeons ranked “overall appearance of nose” first and “ability to breathe through nose while awake” second. There were strong correlations between patients’ and surgeons’ rankings (Spearman’s ρ=0.836, P=0.002), between patients’ and the general population’s rankings (Spearman’s ρ=0.773, P=0.007), and between surgeons’ and the general population’s rankings (Spearman’s ρ=0.782, P=0.006). Our results highlight a significant correlation between characteristics of the “ideal” nose as determined by patients, surgeons, and the general population.

Objective: To evaluate the 2020 to 2021 Otolaryngology residency application cycle in the context of recent trends.Study Design: Retrospective data analysis.Setting: Disruptions caused by the COVID-19 pandemic may significantly alter trends among residency applicants, especially in highly competitive and/or smaller specialties.Methods: Applicant and residency statistics from Electronic Residency Application Service (ERAS) and National Residency Matching Program (NRMP) were extracted from the 2016 to 2021 and 2011 to 2021, respectively. Trends in Otolaryngology-Head and Neck Surgery (OHNS) were compared to peer specialties (PS) including Dermatology, Neurological Surgery, Orthopedic Surgery, and Integrated Pathway for Plastic and Reconstructive Surgery (PRS). The ratio of the number of applicants per positions (APP) was used to reflect the degree of competition.Results: Between 2011 and 2021, the number of OHNS programs and positions expanded less than those of PS and General Surgery. The increase in the APP ratio was significantly greater for OHNS compared to those Dermatology, Orthopedic Surgery, General Surgery and all PGY1 residency positions for both US MD and all applicants (P< .01 for each). OHNS expansion of US MD (P= .046), but not all applicants (P= .169), outgrew that of Neurosurgery.Conclusion: The 2020 to 2021 cycle affected by the COVID-19 pandemic saw a continuation of the recent trend in the expanding OHNS applicant pool. OHNS remains one of the specialties with the highest APP ratio and has observed a significant growth compared to PS since 2018. Understanding and anticipating trends in residency application cycles is critical for designing processes to optimize the best fit between applicants and programs.

Purpose: To evaluate the recent Otolaryngology-Head and Neck Surgery (OTO-HNS) applicant characteristics, to identify which applicant characteristics are associated with successful match into OTO-HNS, and to compare OTO-HNS applicant trends and characteristics to that of peer surgical specialties (PS).Materials and Methods: Data were obtained from official reports by the National Residency Matching Program (NRMP) for OTO-HNS, plastic and reconstructive surgery, orthopedic surgery, neurosurgery, and dermatology from 2006 to 2019. Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination (USMLE) scores, research productivity, graduation from a top-40 NIH-funded U.S. medical school, and additional graduate degree were recorded. Odds ratios (OR) were calculated to evaluate the relationship between applicant qualifications and match success.Results: From 2014 to 2018, the OTO-HNS applicant pool shrunk from 443 to 333, representing the largest drop of all PS. Furthermore, OTO-HNS reported the most unfilled positions and highest match rates in 2017 (n = 14; 92.1%) and 2018 (n = 12; 94.6%) among any PS. Despite recent trends, 2019 NRMP data revealed a 38.74% increase in OTO-HNS applicant numbers compared to 2018. AOA membership (OR, 7.3; P= .030), USMLE Step 2 scores between 241 and 260 (OR, 6.5; P= .009), and research productivity (OR, 5.6; P= .005) significantly increased the odds of matching into OTO-HNS.Conclusions: Despite recent fluctuations in application trends, OTO-HNS continues to successfully match highly qualified applicants, including applicants with AOA membership, high Step 2 scores, and high research productivity. An understanding of the qualifications used to evaluate residency applicants may be helpful to both applicants and residency programs of OTO-HNS.

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Dynamization of fracture fixation constructs provides early rigidity for primary bone healing and late motion for secondary healing. A review of laboratory, animal, and clinical studies investigating the impact, and optimal timing, of dynamization is limited by lack of standardization across studies. However, in animal models, dynamization improves histologic and biomechanical properties compared with statically rigid or flexible controls. In animals, dynamization at 3 to 4 weeks showed improved histologic results. In clinical studies, it showed faster, stronger, and stiffer bone healing. Clinical success dynamizing external fixators and intramedullary nails suggests a role for late dynamization in other fixation types, such as bridge plating. [Dynamization of fracture fixation constructs provides early rigidity for primary bone healing and late motion for secondary healing. A review of laboratory, animal, and clinical studies investigating the impact, and optimal timing, of dynamization is limited by lack of standardization across studies. However, in animal models, dynamization improves histologic and biomechanical properties compared with statically rigid or flexible controls. In animals, dynamization at 3 to 4 weeks showed improved histologic results. In clinical studies, it showed faster, stronger, and stiffer bone healing. Clinical success dynamizing external fixators and intramedullary nails suggests a role for late dynamization in other fixation types, such as bridge plating. [Orthopedics. 2020;43(3):e125–e133.]

Lipomas are among the most commonly presenting benign forehead masses. They commonly cause cosmetic concerns for patients. The purpose of this report is to introduce a novel endoscopic technique allowing for forehead soft tissue mass removal with superior cosmetic outcomes. We detail a case of a large 3.5-cm lateral forehead lipoma that was successfully removed endoscopically through a single incision via a subtemporoparietal approach. The lipoma presented is the largest documented case removed endoscopically using this approach. We introduce a novel technique using a single incision in the temporal area to remove a forehead mass via a dissection between the temporoparietal fascia and deep temporal fascia. Our broad literature search only found one other report of this approach used for forehead lipoma removal. Our report further validates this approach and highlights its efficacy in removing large masses. Patients with cosmetic concerns about having a facial scar, children, and those with predisposition for keloids or hyperpigmented/hypertrophic scars stand to benefit most from this procedure. When comparing the endoscopic approach with the commonplace open-incision approach, our approach shows superior cosmetic results, less risk of damage to important neurovascular structures, and, most importantly, higher patient satisfaction. Even when contrasting the technique outlined in this report versus other endoscopic approaches, our method produces enhanced results.