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The aim of this study was to characterize major topics of discussion in oculoplastic surgery on a social media forum and to evaluate the medical accuracy of the content discussed on these platforms.Methods: A cross-sectional analysis of oculoplastics key search terms was performed on 2 active forums (r/ PlasticSurgery and r/CosmeticSurgery) on Reddit. The content analysis involved the top posts in Reddit's history from 2008 to 2022. Medical accuracy was determined by actively practicing, board-certified, and fellowship-trained oculoplastic surgeons.Results: The most common topics of patient discussions involved inquiring for advice regarding a procedure (44%) and sharing before-and-after photos (34%). The most common topics of patient discussions included providing support, encouragement, or sympathy for a patient (80%) and the cost of a procedure (62%). Misunderstanding of the medical pathophysiology of the patient's condition was seen in 68% of discussions on this social media platform. Medically inaccurate information was seen in 31% of all analyzed statements. When the type of physician performing a given procedure was disclosed, half reported an oculoplastic surgeon performed the surgery.Conclusions: The social media platform, Reddit, is a popular source of advice and information for current and prospective oculoplastic surgery patients. Such social media forums should be used as a sort of psychosocial and psychological support rather than as a primary source of medical information.

Purpose: To evaluate the association between risk of obstructive sleep apnea (OSA) and severity of thyroid eye disease (TED) using a validated OSA screening tool. Methods: A prospective, observational cohort study was performed. New adult TED patients were offered OSA screening with the Snoring Tired Observed Pressure (STOP)-Bang survey during their initial evaluation. Clinical examination and treatment for TED were standard of care and utilized the International Thyroid Eye Disease Society Vision Inflammation Strabismus Appearance system. At the conclusion of the study period, analysis was performed correlating maximum severity of TED signs and symptoms between high- and low-risk OSA groups. Multivariate logistic and linear regression analyses were also performed to analyze the association between the numerical STOP-Bang score and maximum severity of the potentially actionable clinical features of TED (compressive optic neuropathy, vertical prism deviation, horizontal prism deviation, exophthalmos, vertical fissure height). Results: Eighty-five patients met inclusion criteria. Twenty-eight percent were at high risk of OSA (STOP-Bang score of 3 or higher). When comparing the low- and high-risk cohorts, increased risk of OSA was significantly associated with the development of TED compressive optic neuropathy (p = 0.014), conjunctival injection (p = 0.027), chemosis (p = 0.013), upper eyelid edema (p = 0.024), lower eyelid edema (p = 0.003), eyelid erythema (p = 0.037), and vertical strabismus (p = 0.047). In the multivariate regression analyses, higher STOP-Bang scores correlated with increased risk of TED compressive optic neuropathy (p = 0.006), vertical strabismus (p = 0.019), and higher subjective diplopia scores (p = 0.045). Conclusions: Increased risk of OSA, as determined by the STOP-Bang survey, is associated with increased severity of multiple clinical features of TED, including TED compressive optic neuropathy and strabismus.

Richter's hernia, also called a partial enterocele, involves a protrusion of peritoneum with subsequent strangulation or incarceration of only part of the lumen of the anti-mesenteric portion of the small bowel through a fascial defect. We report a rare presentation of incarcerated incisional Richter's hernia of the cecum in a 39-year-old female. The patient presented with acute abdominal pain that gradually improved. Physical examination revealed right lower quadrant tenderness and nodularity just above an abdominoplasty scar. Subsequent computed tomography scan demonstrated a 1 cm by 1 cm hypovascular pocket arising from the cecum with protrusion into the anterior abdominal wall. The hernia was successfully repaired surgically with resolution of symptoms. It is essential for clinicians to be mindful of the diagnosis of Richter's hernia on the differential for abdominal pain as the risk of detrimental outcomes increases with delayed surgical intervention.

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During routine cadaveric dissection of a 59-year-old female cadaver, a rare, anomalous fusion of the semitendinosus and long head of the biceps femoris muscles, arising as a common head at the origin of the ischial tuberosity, was observed. In addition, a unilateral muscular slip was noted between the gluteus maximus and the long head of the biceps femoris muscle belly. To the best of our knowledge, this variation has not been previously reported in the literature. Such variations may increase the risk of hamstring injury or compression of the sciatic nerve. Patients presenting with sciatic pain in the posterior thigh may prompt an evaluation for the aberrant origin of the hamstring muscles. It may be beneficial for surgeons, radiologists, and sports medicine specialists to be aware of such variations due to potential implications on surgical intervention, pain management, and interpretation of radiographic images.

Purpose To report previously undocumented variants of the neurovascular course of the profunda brachii artery. Methods During routine cadaveric dissection, a unique combination of variations in the neurovascular course of the profunda brachii artery was noted in the right upper extremity of a 67-year-old female cadaver. Results The brachial artery was observed entirely anterior to the median nerve and its roots. The median nerve received an additional contribution from a branch of the lateral cord that communicates with the medial cord. The profunda brachii artery also took abnormal origin from the subscapular artery, rather than the brachial artery, in the same limb. Conclusion This report presents a unique combination of three neurovascular variations in the right upper limb of a single cadaver. Understanding variability in the course and continuation of the profunda brachii artery may assist surgeons and other interventionists in safely and effectively operating within the upper extremity.

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