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9%). Prior chemoradiotherapy and cancer diagnosis predisposed patients to long-term complications. At the 5-year follow-up, 21.7% of patients had experienced a long-term complication. CONCLUSIONS Long-term complications after OCFF occurred in 17% of patients. In this series, a preoperative history of chemoradiation and those undergoing maxillary reconstruction were at high risk for the development of long-term complications and thus warrant diligent follow-up. However, OCFFs can often enjoy long-term viability and survival, even in the case of perioperative complications and salvage surgery.Facial analysis is a foundational aspect of facial plastic and reconstructive surgery. Unfortunately, ideal proportions of beauty are commonly discussed without much thought regarding their historical derivation and associated cultural implications. Facial analysis often is limited to narrow ethnic and gender-normative aesthetics. As we evolve as a specialty that treats disparate patient populations and embraces a diverse community of surgical trainees, it may be time to reframe our approach to facial analysis education.OBJECTIVE Tympanic membrane (TM) fibroblast cytotoxicity of quinolone ear drops is enhanced by dexamethasone and fluocinolone. Hydrocortisone has not been evaluated. We aimed to assess the effects of these 3 steroids on mouse and human TM fibroblast survival. STUDY DESIGN In vitro. SETTING Academic laboratory. SUBJECTS AND METHODS Mouse and human TM fibroblasts were exposed to hydrocortisone, dexamethasone, or fluocinolone at concentrations in commercial ear drops (1%, 0.1%, or 0.025%, respectively) and at steroid potency equivalents (1%, 0.033%, or 0.0033%, respectively), or dilute ethanol (control), twice within 24 hours or 4 times within 48 hours for 2 hours each time. Cells were observed with phase-contrast microscopy until the cytotoxicity assay was performed. RESULTS Mouse and human TM fibroblasts treated with any of the steroids had lower survival after 24 and 48 hours compared to control (all P .05), but hydrocortisone had lower survival in both mouse (P = .02 and P less then .0001) and human (P less then .0001) fibroblasts. Phase-contrast images mirrored the cytotoxicity findings. CONCLUSION Steroids found in commercial ear drops reduce survival of mouse and human TM fibroblasts. Hydrocortisone appears to be more cytotoxic than the more potent steroids, dexamethasone and fluocinolone. These findings should be considered when assessing clinical outcomes of ototopical preparations.Several prominent domain general theories (e.g., processing speed and inhibitory function) have been developed to explain cognitive changes associated with aging. A bias to "pattern complete" in aging has also been suggested to account for some of the age-related changes in episodic memory. The current experiments test whether domain-general processes of cognitive aging moderate age-related performance decrements on the mnemonic similarity task, a task thought to rely on hippocampal pattern separation and completion. The study phase of the mnemonic similarity task, a memory task with old, new, and similar trials at recognition, was manipulated to assess the contribution of processing speed (Experiment 1 - different encoding times) and inhibitory function (Experiment 2 - item-level directed forgetting) to age-related performance differences in a sample of 100 healthy younger and older adults. Both experiments exhibited significant interactions between age group and encoding manipulation, replicating a decrement in performance in older adults, and indicating that processing speed and inhibitory function moderate this effect. Results suggest that age-related differences in performance on the mnemonic similarity task can at least partially be accounted for by experimental manipulations of domain general processes that also decline with age.OBJECTIVE To relate maxillary and lingual frenulum configuration to breastfeeding success. STUDY DESIGN Cross-sectional study. SETTING Newborn nursery in tertiary care academic hospital. SUBJECTS AND METHODS Newborns were observed between 24 and 72 hours after birth. Mothers were asked a series of questions relating to their breastfeeding experience. The maxillary and lingual frenula were examined and scored. Corresponding LATCH scores were recorded. RESULTS A total of 161 mothers with newborns participated. The mean gestational age of newborns was 38.81 weeks (95% CI, 38.65-38.98); 82 (50.9%) male and 79 (49.1%) female newborns were included. find more In sum, 70.8% had the maxillary frenulum attached to the edge of the alveolar ridge; 28.6%, attached to the fixed gingiva; and 0.6%, attached to mobile gingiva. In addition, 3.7% had anterior ankyloglossia, and 96.3% had no obvious anterior ankyloglossia. There was no significant correlation between maxillary frenulum scores or lingual frenulum scores and LATCH scores (P > .05). Of the mothers included in the study, 56.5% were first-time mothers. Overall, 43.5% of the mothers had other biological children, with 70.0% of those mothers having previously breastfed. Experienced mothers who had breastfed for >3 months had significantly higher LATCH scores. Those who had previously breastfed had a mean LATCH score of 9.16 (95% CI, 8.80-9.52), as compared with those who had not, with a mean of 8.14 (95% CI, 7.43-8.85). CONCLUSION We did not find that maxillary frenulum configuration correlated with LATCH scores. Mothers experienced with breastfeeding had better LATCH scores. Attention toward breastfeeding education, particularly in new mothers, should precede maxillary frenotomy in neonates with breastfeeding difficulties.OBJECTIVE To investigate audiometric outcomes and incidence of chronic ear disease following lateral skull base repair (LSBR) of cerebrospinal fluid (CSF) leaks. STUDY DESIGN Retrospective review. SETTING Tertiary skull base center. SUBJECTS AND METHODS Consecutive adults undergoing LSBR of CSF leaks between 2012 and 2018 were reviewed. Audiometric data included mean air conduction pure-tone average (PTA), air-bone gap (ABG), speech recognition threshold (SRT), and word recognition score (WRS). The incidence and management of the following were collected effusion, retraction, otitis media and externa, perforation, and cholesteatoma. RESULTS Seventy-three patients underwent transmastoid (n = 5), middle cranial fossa (n = 2), or combined approach (n = 67) for repair of spontaneous leaks (sCSFLs, n = 41) and those occurring in the setting of chronic ear disease (ceCSFLs, n = 32). ABG decreased 7.23 dB (P = .01) in sCSFL patients. Perforations (P = .01) were more likely in ceCSFL. No sCSFL patient developed a cholesteatoma, perforation, or infection.
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