Background Nasal osteotomy is a commonly performed procedure during rhinoplasty for both functional and cosmetic reasons. Teaching and learning this procedure proves difficult due to the reliance on nuanced tactile feedback. For surgical simulation, trainees are traditionally limited to cadaveric bones, which can be costly and difficult to obtain. Objective This study aimed to design and print a low-cost midface model for nasal osteotomy simulation. Methods A 3D reconstruction of the midface was modified using the free open-source design software Meshmixer (Autodesk Inc). The pyriform aperture was smoothed, and support rods were added to hold the fragments generated from the simulation in place. Several models with various infill densities were printed using a desktop 3D printer to determine which model best mimicked human facial bone. Results A midface simulation set was designed using a desktop 3D printer, polylactic acid filament, and easily accessible tools. A nasal osteotomy procedure was successfully simulated using the model. Conclusions 3D printing is a low-cost, accessible technology that can be used to create simulation models. With growing restrictions on trainee duty hours, the simulation set can be used by programs to augment surgical training.

When EH coexists with vestibular schwannoma in a patient presenting with recurrent vertigo spells, medical treatments for EH may alleviate the vestibular symptoms. We recommend that patients with small vestibular schwannomas who present with vertigo spells undergo high resolution MRI to evaluate for EH and undergo a trial of medical treatment with diuretics.

Introduction: First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain of severe facial pain in the ipsilateral parotid region with the first few bites of a meal. Objective: The aim of this study is to shed light on the incidence and potential risk factors of FBS, including a series of cases depicting FBS observed after parotidectomy. Methods: Retrospective review of 419 patients who underwent parotidectomy at a single tertiary care facility between December 2016 and June 2020. Results: With a mean follow-up time of 16.5 months, 8 (2%) patients were documented to have symptoms of FBS after parotid gland surgery. Six of these patients underwent partial parotidectomy by dissection of the deep lobe of the parotid (DLP). Conclusion: Patients undergoing dissection of the DLP are particularly at risk for the development of FBS. All patients should be appropriately counseled during informed consent discussions, especially in high-risk cases.

Head and neck cancers are frequently associated with dysphagia. Both pre-treatment and post-treatment etiologies have been described in the literature. The result of dysphagia has been well-documented as causing reductions in both quality-of-life and physical wellbeing. The goal of this review is to consolidate the current understanding of the relationship between head and neck cancers and dysphagia.

ObjectiveTo assess the needs of transgender and nonbinary (TNB) adults for gender‐affirming face, neck, and voice procedures.Study DesignCross‐sectional survey.SettingOnline, February to May 2022.MethodsPrimary outcomes included utilization of otolaryngologists and speech‐language pathologists; gender dysphoria felt from the face, neck, and voice self‐reported on a 0 to 10 numeric rating scale (0 = no dysphoria, 10 = unbearable); and desire for various gender‐affirming face, neck, and voice procedures. We used ordinal logistic and linear regression to assess relationships between site‐specific dysphoria and the desire for relevant procedures.ResultsTNB participants (N = 234) infrequently sought gender‐affirming care with speech‐language pathologists (23%), facial plastic surgeons (8%), or laryngologists (3%). Participants experienced the strongest dysphoria from the voice (median 7/10), jawline/chin (4/10), and neck (3.5/10). Transmasculine and nonbinary participants typically seeking masculinization (n = 83) frequently desired voice therapy (want = 35%, had = 8%). Transfeminine and nonbinary participants typically seeking feminization (n = 145) frequently desired voice therapy (want = 52%, had = 23%), chondrolaryngoplasty (want = 45%, had = 5%), and hair removal/electrolysis (want = 43%, had = 44%). Many desired at least 1 facial feminization surgery procedure (65%), especially mandible reduction (want = 42%, had = 3%), rhinoplasty (want = 41%, had = 1%), and forehead reduction (want = 37%, had = 4%). Dysphoria ratings were associated with desiring relevant procedures (p < .05 for all), notably voice therapy (odds ratio [OR] = 1.50), chondrolaryngoplasty (OR = 1.46), mandible reduction (OR = 1.38), rhinoplasty (OR = 1.59), and forehead reduction (OR = 1.82).ConclusionGender dysphoria from the face, neck, and voice can be severe for TNB people and is associated with the desire for gender‐affirming procedures. The high demand yet low reported access to these procedures highlights the need for providers of gender‐affirming face, neck, and voice care.

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This is the first study to report on the prevalence of cosmetic facial plastic surgery use among facial plastic surgeons. The aim of this study is to determine the frequency with which facial plastic surgeons have cosmetic procedures themselves. A secondary aim is to determine whether trends in usage of cosmetic facial procedures among facial plastic surgeons are similar to that of nonsurgeons. The study design was an anonymous, five-question, Internet survey distributed via email set in a single academic institution. Board-certified members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) were included in this study. Self-reported history of cosmetic facial plastic surgery or minimally invasive procedures were recorded. The survey also queried participants for demographic data. A total of 216 members of the AAFPRS responded to the questionnaire. Ninety percent of respondents were male ( = 192) and 10.3% were female ( = 22). Thirty-three percent of respondents were aged 31 to 40 years ( = 70), 25% were aged 41 to 50 years ( = 53), 21.4% were aged 51 to 60 years ( = 46), and 20.5% were older than 60 years ( = 44). Thirty-six percent of respondents had a surgical cosmetic facial procedure and 75% has at least one minimally invasive cosmetic facial procedure. Facial plastic surgeons are frequent users of cosmetic facial plastic surgery. This finding may be due to access, knowledge base, values, or attitudes. By better understanding surgeon attitudes toward facial plastic surgery, we can improve communication with patients and delivery of care. This study is a first step in understanding use of facial plastic procedures among facial plastic surgeons.

ObjectiveTo assess transgender and nonbinary adults’ awareness of Otolaryngologists’ (ENT) and speech‐language pathologists’ (SLP) ability to perform various face, neck, and voice procedures for gender‐affirming purposes.Study DesignCross‐sectional survey.SettingOnline, from February to May 2022.MethodsWe developed a list of nonsurgical and surgical gender‐affirming face, neck, and voice procedures. We asked transgender and nonbinary (TNB) adults which procedures from this list they knew could be performed by specially‐trained ENTs or SLPs for gender‐affirmation and which listed procedures they knew existed as gender‐affirming treatment before the survey. We assessed awareness of ENTs’ and SLPs’ ability for each procedure across gender identity using Fisher exact tests. We examined if demographic or socioeconomic factors were associated with the total number of gender‐affirming procedures participants knew ENTs or SLPs could perform using univariable linear regression.ResultsTNB adults (N = 234) generally knew these procedures existed as gender‐affirming treatment (64%‐93%). However, TNB adults were largely unaware these gender‐affirming procedures could be performed by specially‐trained ENTs or SLPs (53% or less), especially procedures unrelated to the voice, neck, and nose (26% or less). Knowledge of ENTs' and SLPs' ability was similar across gender identity for most procedures. Total number of procedures known that ENTs or SLPs could perform did not differ by demographic/socioeconomic factors (p > .05).ConclusionThese findings suggest transgender and nonbinary individuals may not know to seek Otolaryngologists or SLP when desiring gender‐affirming face, neck, or voice care. Increased efforts are needed to promote awareness of Otolaryngology's role in providing gender‐affirming care.Level of Evidence4.