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Modabber A, Winnand P, Hölzle F, Ilgner J, Hackenberg S. [Current developments in primary and secondary surgical treatment of midface and periorbital trauma]. HNO 2022; 70:756-764. [PMID: 36044058 DOI: 10.1007/s00106-022-01226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/04/2022]
Abstract
Fractures of the periorbita and the midface are among the most common bony facial injuries. Aesthetic and functional reconstruction is a challenge in clinical routine. This article illustrates recent developments in the primary and secondary surgical treatment of midface and periorbital trauma. Resorbable patches and films increase the anatomic reconstructive capacity and enable treatment of extensive orbital fractures. Orbital fractures with involvement of supporting key structures are advantageously reconstructed using patient-specific implants (PSI), which are fabricated by computer-assisted manufacturing techniques and positioned by intraoperative navigation. If late complications such as bulbar malposition and enophthalmos have occurred after the initial procedure, they can be addressed by overcorrective restoration of orbital volume. The use of PSI for initial fracture restoration of the midface is not yet established but may be useful in re-osteotomies of misconsolidated fragments. Extensive midface defects with significant soft tissue involvement can be reconstructed using microvascular grafts. Consecutive reconstructive procedures may include orthognathic surgery and local flap reconstruction. In summary, the integration and advancement of computer-assisted techniques now offers individualized reconstruction procedures, which may be a viable alternative to conventional implants and compression miniplates. Future developments may focus on the search for innovative biomaterials, which can be integrated into computer-aided design and manufacturing processes.
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Affiliation(s)
- A Modabber
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - P Winnand
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - F Hölzle
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - J Ilgner
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik RWTH Aachen, Aachen, Deutschland
| | - S Hackenberg
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik RWTH Aachen, Aachen, Deutschland
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Choi AM, Brenner MJ, Gorelik D, Erbele ID, Crowson MG, Kadkade P, Takashima M, Santa Maria PL, Hong RS, Rose AS, Ostrander BT, Rabbani CC, Morrison RJ, Weissbrod PA, Tate AD, Kain JJ, Lina IA, Shaffer SR, Ahmed OG. New Medical Device and Therapeutic Approvals in Otolaryngology: State of the Art Review of 2021. OTO Open 2022; 6:2473974X221126495. [PMID: 36171808 PMCID: PMC9511340 DOI: 10.1177/2473974x221126495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate new medical devices and drugs pertinent to otolaryngology–head and neck surgery that were approved by the Food and Drug Administration (FDA) in 2021. Data Sources Publicly available FDA device and drug approvals from ENT (ear, nose, and throat), anesthesia, neurosurgery, plastic surgery, and general surgery FDA committees. Review Methods FDA device and therapeutic approvals were identified and reviewed by members of the American Academy of Otolaryngology–Head and Neck Surgery’s Medical Devices and Drugs Committee. Two independent reviewers assessed the relevance of devices and drugs to otolaryngologists. Medical devices and drugs were then allocated to their respective subspecialty fields for critical review based on available scientific literature. Conclusions The Medical Devices and Drugs Committee reviewed 1153 devices and 52 novel drugs that received FDA approval in 2021 (67 ENT, 106 anesthesia, 618 general surgery and plastic surgery, 362 neurosurgery). Twenty-three devices and 1 therapeutic agent relevant to otolaryngology were included in the state of the art review. Advances spanned all subspecialties, including over-the-counter hearing aid options in otology, expanding treatment options for rhinitis in rhinology, innovative laser-safe endotracheal tubes in laryngology, novel facial rejuvenation and implant technology in facial plastic surgery, and advances in noninvasive and surgical treatment options for obstructive sleep apnea. Implications for Practice FDA approvals for new technology and pharmaceuticals present new opportunities across subspecialties in otolaryngology. Clinicians’ nuanced understanding of the safety, advantages, and limitations of these innovations ensures ongoing progress in patient care.
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Affiliation(s)
- Alexander M. Choi
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Michael J. Brenner
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Daniel Gorelik
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Isaac D. Erbele
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - Matthew G. Crowson
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Prajoy Kadkade
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, North Shore University Hospital, Sunnyside, New York, USA
| | - Masayoshi Takashima
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Peter L. Santa Maria
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Robert S. Hong
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University, Detroit, Michigan, USA
- Michigan Ear Institute, Farmington Hills, Michigan, USA
| | - Austin S. Rose
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Benjamin T. Ostrander
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA
| | - Cyrus C. Rabbani
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Case Western Reserve University and University Hospitals, Cleveland, Ohio, USA
| | - Robert J. Morrison
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Philip A. Weissbrod
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA
| | - Alan D. Tate
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - Joshua J. Kain
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Ioan A. Lina
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Scott R. Shaffer
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Marlton, New Jersey, USA
| | - Omar G. Ahmed
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
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