The Experts below are selected from a list of 276 Experts worldwide ranked by ideXlab platform
Warren Schubert - One of the best experts on this subject based on the ideXlab platform.
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Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings
World Journal of Surgery, 2018Co-Authors: David A Shaye, Irfan Shah, Travis Tollefson, Gopal Krishnan, Damir Matic, Marcelo Figari, Thiam Chye Lim, Sunil Aniruth, Warren SchubertAbstract:Background Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of Craniomaxillofacial (CMF) Trauma education. Methods CMF Trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency. Results A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF Trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed. Conclusions Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (Trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.
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Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings
World Journal of Surgery, 2018Co-Authors: David A Shaye, Irfan Shah, Travis Tollefson, Gopal Krishnan, Damir Matic, Marcelo Figari, Sunil Aniruth, Warren SchubertAbstract:Background Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of Craniomaxillofacial (CMF) Trauma education. Methods CMF Trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency. Results A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF Trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed. Conclusions Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (Trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.
Tom Shokri - One of the best experts on this subject based on the ideXlab platform.
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facial plastic and reconstructive surgery during the covid 19 pandemic implications in Craniomaxillofacial Trauma and head and neck reconstruction
Annals of Plastic Surgery, 2020Co-Authors: Tom Shokri, Robert Saadi, Jeffrey Liaw, Darrin V Bann, Vijay A Patel, Neerav Goyal, Jessyka G LighthallAbstract:Background The global COVID-19 pandemic has had a profound impact on facial plastic and reconstructive surgery. Our review serves as a safety resource based on the current literature and is aimed at providing best-practice recommendations. Specifically, this article is focused on considerations in the management of Craniomaxillofacial Trauma as well as reconstructive procedures after head and neck oncologic resection. Methods Relevant clinical data were obtained from peer-reviewed journal articles, task force recommendations, and published guidelines from multiple medical organizations utilizing data sources including PubMed, Google Scholar, MEDLINE, and Google search queries. Relevant publications were utilized to develop practice guidelines and recommendations. Conclusions The global COVID-19 pandemic has placed a significant strain on health care resources with resultant impacts on patient care. Surgeons operating in the head and neck are particularly at risk of occupational COVID-19 exposure during diagnostic and therapeutic procedures and must therefore be cognizant of protocols in place to mitigate exposure risk and optimize patient care.
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dangers beyond drowning Craniomaxillofacial Trauma in adult water activities
Oral and Maxillofacial Surgery, 2020Co-Authors: Sammy Othman, Tom Shokri, Samuel Bosco, Jason E Cohn, Yadranko DucicAbstract:Water recreation is one of the most popular activities for both fitness and leisure. The dangers of water activities have mostly been examined in the context of drowning and general bodily injuries. Despite the existing research, little is known about adult maxillofacial injuries in these settings. We accessed the National Electronic Injury Surveillance System in order to identify adult patients presenting to emergency departments with Traumatic maxillofacial injuries secondary to a water-based sport or activity over the most recent 10-year period (2009–2018). Data collected included demographical information, anatomical location, mechanism of injury, and visit circumstances, as well as visit disposition. A total of 1350 total patients were identified as appropriate for study inclusion. Young, Caucasian male adults were the most common age group to present with maxillofacial injuries secondary to water sport activities. Surfing and water skiing were associated with lacerations, while diving board incidents posed a higher fracture risk. Patients participating in all water activities were more likely to be treated and released rather than admitted. There appears to be a distinct pattern profile for individuals who sustain maxillofacial Trauma while participating in water sports: young, Caucasian males in particular. Additionally, specific activities may be associated with varying injury types. The results of this study may increase interest in legislature and patient counseling when seeking such activities.
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Management of Complex Mandible Fractures.
Facial plastic surgery : FPS, 2019Co-Authors: Tom Shokri, Emily Misch, Yadranko Ducic, Mofiyinfolu SokoyaAbstract:Mandible fractures represent a common sequela of Craniomaxillofacial Trauma encountered by reconstructive surgeons. Management of complex mandibular fractures, and reestablishment of the occlusal relationship, represents a challenging reconstructive endeavor for even the most skilled surgeon. In this article, the authors review the treatment options for particularly complex presentations of this injury pattern.
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Traumatic orbital apex syndrome an uncommon sequela of facial Trauma
Ear nose & throat journal, 2019Co-Authors: Tom Shokri, Brad E Zacharia, Jessyka G LighthallAbstract:Orbital apex syndrome (OAS) is a rare ocular complication following Craniomaxillofacial Trauma. This Traumatic syndrome is a combination of features seen in both superior orbital fissure syndrome a...
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Traumatic Orbital Apex Syndrome: An Uncommon Sequela of Facial Trauma.
Ear nose & throat journal, 2019Co-Authors: Tom Shokri, Brad E Zacharia, Jessyka G LighthallAbstract:Orbital apex syndrome (OAS) is a rare ocular complication following Craniomaxillofacial Trauma. This Traumatic syndrome is a combination of features seen in both superior orbital fissure syndrome and Traumatic orbital neuropathy due to nerve impingement. Due in part to the rarity of this disorder, the optimal treatment of Traumatic OAS has yet to be determined. We present a case in which Traumatic OAS was caused by direct compression due to a displaced fracture segment from the superior orbit. The patient was successfully treated with a combination of emergent decompression and urgent reconstruction suggesting that this may be an effective strategy in OAS resulting from direct nerve compression as a result of Craniomaxillofacial fracture.
Jessyka G Lighthall - One of the best experts on this subject based on the ideXlab platform.
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facial plastic and reconstructive surgery during the covid 19 pandemic implications in Craniomaxillofacial Trauma and head and neck reconstruction
Annals of Plastic Surgery, 2020Co-Authors: Tom Shokri, Robert Saadi, Jeffrey Liaw, Darrin V Bann, Vijay A Patel, Neerav Goyal, Jessyka G LighthallAbstract:Background The global COVID-19 pandemic has had a profound impact on facial plastic and reconstructive surgery. Our review serves as a safety resource based on the current literature and is aimed at providing best-practice recommendations. Specifically, this article is focused on considerations in the management of Craniomaxillofacial Trauma as well as reconstructive procedures after head and neck oncologic resection. Methods Relevant clinical data were obtained from peer-reviewed journal articles, task force recommendations, and published guidelines from multiple medical organizations utilizing data sources including PubMed, Google Scholar, MEDLINE, and Google search queries. Relevant publications were utilized to develop practice guidelines and recommendations. Conclusions The global COVID-19 pandemic has placed a significant strain on health care resources with resultant impacts on patient care. Surgeons operating in the head and neck are particularly at risk of occupational COVID-19 exposure during diagnostic and therapeutic procedures and must therefore be cognizant of protocols in place to mitigate exposure risk and optimize patient care.
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Traumatic orbital apex syndrome an uncommon sequela of facial Trauma
Ear nose & throat journal, 2019Co-Authors: Tom Shokri, Brad E Zacharia, Jessyka G LighthallAbstract:Orbital apex syndrome (OAS) is a rare ocular complication following Craniomaxillofacial Trauma. This Traumatic syndrome is a combination of features seen in both superior orbital fissure syndrome a...
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Traumatic Orbital Apex Syndrome: An Uncommon Sequela of Facial Trauma.
Ear nose & throat journal, 2019Co-Authors: Tom Shokri, Brad E Zacharia, Jessyka G LighthallAbstract:Orbital apex syndrome (OAS) is a rare ocular complication following Craniomaxillofacial Trauma. This Traumatic syndrome is a combination of features seen in both superior orbital fissure syndrome and Traumatic orbital neuropathy due to nerve impingement. Due in part to the rarity of this disorder, the optimal treatment of Traumatic OAS has yet to be determined. We present a case in which Traumatic OAS was caused by direct compression due to a displaced fracture segment from the superior orbit. The patient was successfully treated with a combination of emergent decompression and urgent reconstruction suggesting that this may be an effective strategy in OAS resulting from direct nerve compression as a result of Craniomaxillofacial fracture.
David A Shaye - One of the best experts on this subject based on the ideXlab platform.
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quantifying aerosolization of facial plastic surgery procedures in the covid 19 era safety and particle generation in Craniomaxillofacial Trauma and rhinoplasty
Facial plastic surgery & aesthetic medicine, 2020Co-Authors: Shekhar K Gadkaree, Adeeb Derakhshan, Alan D Workman, Allen L Feng, Alicia M Quesnel, David A ShayeAbstract:Background: COVID-19 poses a potentially significant infectious risk during procedures of the head and neck due to high viral loads in the nasal cavity and nasopharynx. Facial plastic surgery has significant exposure to these areas during Craniomaxillofacial Trauma procedures and rhinoplasty. Methods: Airborne particulate generation in the 1-10 μm range was quantified with an optical particle sizer in real time during cadaveric-simulated rhinoplasty and facial Trauma conditions. Procedures tested included mandibular plate screw drilling, calvarial drilling, nasal bone osteotomy, nasal dorsal rasping, and piezoelectric saw use. Particulate generation was measured both adjacent to the surgical site and at surgeon mouth level (SML). Results: Mandibular plate screw drilling without irrigation generated significant particulate both adjacent to the surgical site and at SML (p < 0.01). Irrigation mitigated particulate generation at SML to nonsignificant levels. Calvarial drilling additionally produced substantial particulate above baseline adjacent to the surgical site (p < 0.01). Standard nasal osteotomies and dorsal rasping did not generate detectable airborne particulate, whereas piezoelectric saw use was associated with significant particulate generation both adjacent to the surgical site (p < 0.001) and at SML (p < 0.01). At SML, smaller particulate represented a significantly higher proportion of total particulate detected. Conclusions: The majority of Craniomaxillofacial Trauma procedures involve particle generation that may be limited in spread by the use of local irrigation. Most bony work involved in rhinoplasty can be safely performed without a high degree of particle formation. The use of piezoelectric instruments in rhinoplasty should be avoided when concerned for particulate generation.
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quantifying aerosolization of facial plastic surgery procedures in the covid 19 era safety and particle generation in Craniomaxillofacial Trauma and rhinoplasty
Facial plastic surgery & aesthetic medicine, 2020Co-Authors: Shekhar K Gadkaree, Adeeb Derakhshan, Alan D Workman, Allen L Feng, Alicia M Quesnel, David A ShayeAbstract:Background: COVID-19 poses a potentially significant infectious risk during procedures of the head and neck due to high viral loads in the nasal cavity and nasopharynx. Facial plastic surgery has s...
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update on the management of Craniomaxillofacial Trauma in low resource settings
Current Opinion in Otolaryngology & Head and Neck Surgery, 2019Co-Authors: Irfan Shah, Shekhar K Gadkaree, Travis Tate Tollefson, David A ShayeAbstract:PURPOSE OF REVIEW Craniomaxillofacial (CMF) Trauma is a common cause of global morbidity and mortality. Although in high resource settings the management of CMF Trauma has improved substantially over the past several decades with internal rigid fixation technology; these advancements have remained economically unviable and have not yet reached low and middle-income countries (LMICs) en masse. The purpose of this review is to discuss the current management of CMF injuries in low-resource settings. RECENT FINDINGS Trauma injuries remain a global epidemic with head and neck injuries among the most common. CMF Trauma injuries largely occur in LMICs, with motor vehicle Trauma being a common cause. Patients present in a delayed fashion which increases complications. Diagnostic methods are often limited to plain radiographs as computed tomography is not always available. In low-resource settings, CMF Trauma continues to be treated primarily by closed reduction, maxillomandibular fixation, and transosseous wiring, yielding acceptable results through affordable methods. With the advent of less expensive plating systems, internal fixation with plates and screws are gradually finding their place in the management of facial Trauma in low-resource settings. A shortage of CMF surgeons in LMICs is a recognized problem and is being addressed by targeted curricula. SUMMARY CMF Trauma is a major cause of morbidity and mortality globally that remains poorly addressed. Currently, conventional methods of treating CMF Trauma in low-resource settings have evolved to meet resource constraints. The education of CMF surgeons remains a key leverage point in improving CMF Trauma care globally.
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Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings
World Journal of Surgery, 2018Co-Authors: David A Shaye, Irfan Shah, Travis Tollefson, Gopal Krishnan, Damir Matic, Marcelo Figari, Thiam Chye Lim, Sunil Aniruth, Warren SchubertAbstract:Background Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of Craniomaxillofacial (CMF) Trauma education. Methods CMF Trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency. Results A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF Trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed. Conclusions Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (Trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.
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Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings
World Journal of Surgery, 2018Co-Authors: David A Shaye, Irfan Shah, Travis Tollefson, Gopal Krishnan, Damir Matic, Marcelo Figari, Sunil Aniruth, Warren SchubertAbstract:Background Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of Craniomaxillofacial (CMF) Trauma education. Methods CMF Trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency. Results A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF Trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed. Conclusions Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (Trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.
Richard J Redett - One of the best experts on this subject based on the ideXlab platform.
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absorbable fixation devices for pediatric Craniomaxillofacial Trauma a systematic review of the literature
Plastic and Reconstructive Surgery, 2019Co-Authors: Joseph Lopez, Nicholas Siegel, Alvaro Reategui, Muhammad Faateh, Paul N Manson, Richard J RedettAbstract:Background:The purpose of this study was to investigate surgical outcomes with the use of resorbable plating systems for the repair of Craniomaxillofacial Trauma in the pediatric population.Methods:A systematic review of the literature was performed. A descriptive analysis, operative technical data,
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frequency of cervical spine injuries in pediatric Craniomaxillofacial Trauma
Journal of Oral and Maxillofacial Surgery, 2019Co-Authors: Helen Xun, Joseph Lopez, Paul N Manson, Richard J Redett, Halley Darrach, Amir H DorafsharAbstract:ABSTRACT Purpose In pediatric Craniomaxillofacial (CMF) Trauma patients, evaluation for cervical spine injury (CSI) is critical, but there are no studies investigating CSI in this unique population. The aim of this study was to measure the frequency of CSI in pediatric CMF fracture population. Methods A retrospective cohort study of all pediatric patients who presented to the Johns Hopkins Hospital Emergency Department with CMF fractures were examined for concurrent CSI injuries. Patient charts were reviewed for mechanism of injury, type and level of CSI, type and location of CMF fracture patterns, and overall outcome. Data was analyzed for correlation and statistical significance. Results A total of 2966 pediatric patients (ages 0-15) were identified from 1990 to 2010 to have suffered CMF fractures, with an average age of 7 ± 4.73 years, and 1897 (64.0%) male. Of these patients, only five children were found to have concomitant CSIs (0.169% frequency). The frequency of CSI in CMF fracture patients with deciduous, mixed, and permanent dentition was 0, 0.307, and 0.441%, respectively. Of the five identified cases, four had concomitant middle-third facial skeleton fractures, four had concomitant upper-thirds cranial skeletal fracture, and two had concomitant lower-thirds cranial skeletal fractures. Conclusion CSIs in pediatric CMF fracture patients are rare, with a frequency of 0.169%; this is significantly lower than the reported ranges in adults (3.69 to 24%). No child of deciduous dentition was found to have a CSI. The lack of CSI in deciduous CMF fracture patients could be explained by the anatomic differences between pediatric and adult cervical spines and supports conservative imaging for children in this age group. Level of Evidence III