Our national longitudinal comparison demonstrates widening socioeconomic disparities between strip craniectomy and CVR patients. Cranial vault remodeling is more commonly performed in underrepresented minorities and patients with Medicaid, while strip craniectomy is common in the White population and patients with private insurance. While hospital charges and complications were higher among CVR, differences were smaller than expected.

Purpose: Conflicting data exist regarding the incidence, demographics, and abnormalities associated with microtia. Using a large national cohort database, a comprehensive evaluation of microtia in the United States was performed. Methods: The Kids’ Inpatient Database was reviewed over a 15-year consecutive period. Information regarding patient demographics, comorbidities, postoperative complications, and hospital setting was collected. Statistical tests were analyzed using independent t tests and χ 2 analysis. Results: A total of 23,479,792 births over 15 consecutive years from 1997 to 2012 were included in the study. Microtia was identified in 1563 births. Incidence of microtia was higher in males (P<0.01) and patients of Asian or Hispanic race (P<0.01). Patients with microtia had significantly more congenital anomalies relative to the rest of the population (P<0.01). Specifically, cardiac and genitourinary anomalies were 51 and 19 times, respectively, more likely in microtia patients. Risk of associated congenital anomalies with microtia was highest in female and Black patients. 12.6% of all microtia patients had an associated craniofacial syndrome with a comparable postsurgical course to the nonsyndromic population. Conclusion: This study represents the largest national, longitudinal study of microtia allowing for demographic, socioeconomic, and comorbidity commentary. By quantifying relative risk of associated congenital anomalies, it can help inform the type and utility of screening modalities when evaluating microtia patients.

Background: Social media have transformed plastic surgery, intersecting patient education, provider marketing, and academic interactions across the globe. Despite this, social media are seldom used in research. The authors sought to understand the primary incentives and deterrents for patient participation in research efforts. Methods: Facebook groups for craniosynostosis families were identified; the largest two had 11,000 and 7200 members. Facebook group administrators were asked to post an open invitation to enroll in the authors’ study. Interested participants contacted study personnel directly. Materials and written/video instructions were provided for collecting genetic specimens. Participants completed a follow-up survey to assess satisfaction. The authors subsequently conducted virtual neurocognitive sessions for functional assessment. Results: Three hundred thirty-one of 384 genetic study participants (86 percent) were recruited by means of social media. Three hundred forty-three of 472 mailed packages (73 percent) were returned. Novel mutations identified explained craniosynostosis in 10 percent of participants. One hundred ninety-five families completed the follow-up survey. One hundred percent and 95 percent reported that the written and video instructions were helpful, respectively. The most frequently cited obstacles barring participation in research studies was travel to the study site (63 percent), significantly more than indirect monetary costs (p = 0.007), information confidentiality (p < 0.001), time required to participate (p < 0.001), and invasive study procedures (p < 0.001). Ninety-nine percent preferred participating in a study from home rather than a research center. Follow-up neurocognitive studies are ongoing. Conclusions: With proper planning, participation in social media–based research is easy, cost-effective, and time conscious. Requiring travel to a research facility is the factor most likely to deter families from contributing to research. The results emphasize the unrealized potential of social media for advancing research in plastic surgery.