Purpose of review This article aims to provide a comprehensive review of the established and emerging applications of various computer-based technologies and smartphone applications in the field of facial plastic surgery. Recent findings Computer-based technologies and smartphone applications have widespread utility across various domains of facial plastic surgery; these include preoperative consultation, surgical planning, intraoperative navigation, custom implant creation, postoperative assessment, physician productivity, communication, and education. Smartphone applications are being utilized for assessment of patients such as those with facial paralysis. Three-dimensional (3D) imaging and 3D printing has influenced preoperative counseling, surgical planning, and execution. The incorporation of intraoperative navigation has the potential to improve the accuracy and precision of facial reconstruction. Summary Current advances in computer-based technology have made a significant impact on the practice of facial plastic and reconstructive surgery. These technological advances have influenced how we counsel patients, perform procedures, assess outcomes, and learn new techniques.

Key Points 3D printing for virtual surgical planning of nasoseptal flap skull base reconstruction is a viable approach. Results indicate improved mucosal preservation but further research is needed to define impact on quality of life.

Objective To compare billing practices, reimbursement rates, and patient populations of otolaryngology (ORL) physicians practicing in rural and urban settings. Study Design Retrospective cross-sectional study. Setting Medicare Provider Utilization and Payment Data: Physician and Other Supplier Data. Methods Medicare-allowed payments, number of services, and number of patients were gathered along with patient population comorbidity statistics, including average hierarchical condition category risk scores. Results In 2019, 92% of the overall total 8959 ORL physicians practiced in an urban setting. These 8243 urban ORL physicians, on average, billed for 51 (interquartile range [IQR], 31-67) unique Healthcare Common Procedure Coding System (HCPCS) codes, cared for 393 (IQR, 172-535) Medicare patients, performed 1761 (IQR, 502-2070) services, and collected $139,957 (IQR, $55,527-$178,479) per provider. In contrast, the 704 rural ORL physicians, on average, billed for a greater number of unique HCPCS codes (59; IQR, 37-77; P < .001), treated more Medicare patients (445; IQR, 242-614; P < .001), and performed more services (2330; IQR, 694-2748; P < .001) but collected about the same per provider ($141,035; IQR, $56,555-$172,864; P = .426). Older age was associated with rural practice ( P = .027). Among both urban and rural ORL physicians, the variety and complexity of procedures and patient comorbidity profiles were comparable. Conclusion Most ORL physicians practice in large urban settings, a finding potentially related to financial sustainability and career opportunity. With an already small workforce, the aging rural ORL physician population is an identifiable weak point in the otolaryngology specialty that must be addressed with geo-specific recruitment campaigns, rural work incentivization, and the development of career advancement opportunities in rural areas.

Bioabsorbable implants (eg, Latera) have recently been approved for addressing nasal valve collapse. The purpose of this study is to summarize adverse events and treatment sequelae associated with bioabsorbable nasal implants queried in the Manufacturer and User Facility Device Experience (MAUDE) database. Of the 26 device reports entered between March 2017 and April 2022, the most frequently reported complications included abscess (n = 13) and implant protrusion (n = 5). Other common symptoms reported greater than 1-year postimplantation included facial pain/discomfort (n = 3) and failure to absorb (n = 3). Management of adverse events included treatment with antibiotics (n = 9), steroid injections (n = 4), and explantation (n = 20). In 3 reports, adverse reactions required a biopsy of adjacent tissue for pathologic analysis. These findings suggest that further research is required to assess the potential longterm complications and optimize the management of bioabsorbable nasal implants. Furthermore, standardized reporting templates may improve the utility of the MAUDE database.

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