Ochoa, Pablo

Introduction: Despite ongoing diversity initiatives, Otolaryngology – Head and Neck surgery continues to face a widening representation gap as the Latinx population in the United States grows. To address this disparity, novel strategies for recruiting Latinx medical students into the specialty must be explored. Methods: A descriptive, cross-sectional survey was distributed to Latinx medical students in the United States via social media platforms (Facebook, Twitter, Instagram) and Latino Medical Student Association (LMSA) chapters. Results: Most respondents were unfamiliar with Otolaryngology-specific health disparities affecting Latinx communities and indicated an interest in learning more about these disparities. Most respondents indicated that early exposure to Otolaryngology disparities affecting Latinx communities could increase interest in exploring the specialty. Additionally, most participants deemed a department's commitment to diversity, equity and inclusion and opportunities to serve Latinx patients to be necessary residency program attributes when deciding between programs (69.2% and 66.7%, respectively). Conclusion: Integrating community outreach and education on Otolaryngology-related health disparities into undergraduate medical education may serve as a promising strategy to enhance Latinx recruitment and representation in the specialty.

AbstractPurposeThe small and complex space of the intranasal cavity poses a challenge to teaching and learning sinonasal anatomy in undergraduate medical education. Evidence suggests that utilizing 3D‐printed (3DP) models is an effective means to comprehend anatomical structures and their spatial relationships. In this study, we introduce and evaluate the educational value of rigid nasal endoscopy on realistic 3DP and silicone‐cast sinus models as a method to teach medical students intranasal anatomy.MethodsTwelve first‐year medical students participated in an educational rigid‐nasal endoscopy workshop led by Otolaryngology PGY‐2 residents and rhinology consultants. The workshop consisted of (1) an introductory PowerPoint on rigid nasal endoscopy and basic intranasal anatomy, (2) timed trials that tested students' ability to locate intranasal anatomical structures while scoping with a rigid endoscope, and (3) pre‐ and post‐surveys.ResultsParticipants improved in their ability to locate each intranasal anatomical structure during the timed trials. Participants felt that rigid endoscopy of 3DP models was an effective method to learn intranasal anatomy compared to their traditional medical school anatomy course.ConclusionThe results of this study suggest that rigid nasal endoscopy of 3DP sinus models is a potentially high‐value educational method for teaching intranasal anatomy to first‐year medical students. Students enjoyed the opportunity to learn intranasal anatomy while practicing a clinically relevant procedure ‐ rigid nasal endoscopy.

Background: Facial aberrant reinnervation syndrome (FARS) is a common sequelae of facial nerve injury followed by aberrant reinnervation and recovery. Patients with FARS can present with different patterns of facial synkinesis, facial muscle hypertonicity, and facial spasm/twitching. 1 Synkinesis associated with FARS is described as undesired muscle contraction when a voluntary movement is triggered. One of the most common and bothersome types of facial synkinesis is oral-ocular synkinesis, where patients experience unwanted eyelid closure with movement of the mouth such as smiling or pursing the lips. First-line treatment options for FARS include facial physical therapy and botulinum toxin selective chemodenervation. For patients with persistent or more significant symptoms, there are surgical options, including selective neurectomy and selective myectomy of the involved facial nerve branches and muscles. 2 , 3 Selective myectomy of the orbicularis oculi muscle has been shown to be an effective surgical treatment option for oral-ocular synkinesis. 3 – 4 There is nuance to this procedure, including deciding whether to target the upper eyelid, lower eyelid, or both, as well as which segments and how much of the orbicularis oculi muscle to remove, balancing the goals of improving synkinesis and hypertonicity while avoiding the creation of lagophthalmos. The novel implementation of autologous microfat grafting to the procedure can help improve postoperative eyelid volume and contour and may help prevent the cut edges of the muscle from fusing, thus reducing the likelihood of persistent or recurrent ocular synkinesis. Objective: To describe a selective myectomy of the orbicularis oculi with the novel addition of autologous microfat grafting for the treatment of oral-ocular synkinesis. Methods: This video demonstrates the procedural steps for a selective myectomy of the orbicularis oculi with autologous microfat grafting for a patient with oral-ocular synkinesis due to FARS. In addition, it demonstrates the preparation of harvested abdominal fat that is utilized for the autologous microfat grafting. Results: Selective myectomy of the orbicularis oculi with autologous microfat grafting has been routinely performed safely and effectively by the senior author for treatment of oral-ocular synkinesis. Postoperative aesthetic eyelid shape and functional results have been reassuring with improvements up to 1 year postoperative and a need for additional long-term follow-up. Conclusion: To the authors’ knowledge, a selective myectomy of the orbicularis oculi with autologous microfat grafting has not been demonstrated in video documentation. Autologous microfat grafting may be a helpful addition to selective myectomy of the orbicularis oculi to enhance both eyelid aesthetics and function. Patient Consent Statement: All patients included in the video have consented to the use of videos and photographs of their faces for research and educational purposes. Funding and Conflicts of Interest: The authors have no funding, financial relationships, or conflicts of interest to disclose. Runtime of video: 7 mins 11 secs.

Background: Residency programs have developed monetary initiatives for students underrepresented in medicine (URiM). Our team sought to provide a centralized resource for URiM students seeking plastic surgery subinternships with funded opportunities. Methods: A cross sectional analysis of URiM scholarships offered by US integrated plastic surgery programs (n = 91) between July and September 2023. The study used residency program web domains. Investigators collected information on the monetary value of scholarship, eligibility criteria, and required application documents. Inferential analyses were conducted to investigate whether programs’ geographic region or Doximity ranking played a role in likelihood of scholarship existence. Results: The study found that approximately 52.7% (n = 48) of programs have in place monetary support for underrepresented visiting medical students (eg, stipend or reimbursement). The average monetary support was $1670. A univariate test demonstrated that programs with lower rankings in both reputation and research were less likely to have a scholarship available than higher ranking programs (P = 0.002; P = 0.02, respectively). Programs located in the Midwest regions were 3.5 times more likely to have a diversity scholarship available (P = 0.034). In our multivariate analysis, reputation ranking and geographic region remained significant. A Pearson chi square test showed the greatest proportions of scholarships among geographically similar programs to be in the Midwest (70%), however, not statistically significant. Conclusions: This study provides a centralized resource for URiM students interested in completing away rotations. Further investigation into development of these scholarship opportunities would be of much benefit and could guide other programs in the funding their own diversity scholarships.

Background: The Schnur scale used body surface area (BSA) to determine the amount of breast tissue resection in reduction mammaplasty, resulting in a greater requirement of breast weight removal in patients with larger BSA. The authors aimed to demonstrate BSA variance among women with similar mastectomy weights and the range of mastectomy weights among women with comparable BSAs. Methods: A retrospective chart review of patients who underwent mastectomy from October of 2021 to June of 2022 was performed. Patients were included if they underwent skin-sparing or nipple-sparing mastectomy with a minimum specimen weight of 700 g. Patient’s BSA, body mass index (BMI), mastectomy weight, and Schnur weight requirement (SWR) were collected. Results: A total of 130 patients (194 breasts) were included. There was significant variance in mean BSA, BMI, SWR, and SWR-to–mastectomy weight ratio among women with similar mastectomy weights. BSA varied by as much as 0.82 units, BMI varied by as much as 32 kg/m2, and SWR varied by as much as 1365 g within the same mastectomy weight group. There was also significant variance in mastectomy weights among women with comparable BSA, especially in BSA groups greater than 2.20, with the greatest range in mastectomy weights being 1684 g. Conclusions: Analysis of mastectomy patients showed no predictable relationship between BSA and breast weight. There was significant variance in the BSA of patients with similar breast weights, and conversely in breast weights of patients with comparable BSA. Therefore, strict adherence to the Schnur weight requirement can prevent patients with macromastia from receiving breast reductions.