In this issue of the Journal of Craniomaxillofacial Trauma and Reconstruction (CMTR), the articles take us from facial feminization surgery through to facial trauma.
We are presented with compelling articles that navigate the complex landscape of gender-affirming facial surgery. In the first article, “Flattening the Curve and Cutting Corners: Pearls and Pitfalls for Facial Gender-Affirming Surgery,” we delve into the intricacies of surgical techniques and practices aimed at achieving optimal outcomes. This report sheds light on the scope of surgery and highlights key strategies for success in this specialized field. Continuing our exploration, the second article challenges conventional wisdom regarding preoperative imaging in feminization cranioplasty. Through a meticulous analysis of reported outcomes in a substantial cohort, the authors advocate for a shift in imaging protocols, emphasizing the judicious use of resources without compromising patient safety or surgical precision. The third article offers a quantitative assessment of surgical success in facial feminization procedures, employing novel metrics such as the nasofrontal angle and projection ratios of key facial landmarks. This study provides valuable insights into evaluating surgical outcomes by utilizing objective measurements. As we look ahead in gender-affirming surgery, we must share and refine techniques to meet the evolving needs of this cohort of patients.
Moving onto facial trauma management, Stanbouly et al highlight the concerning trend of neck injuries associated with trampoline jumping, emphasizing the need for heightened awareness and preventive measures in recreational settings. In contrast, an interrogation of national databases offers intriguing findings regarding the impact of blood alcohol levels on outcomes in patients with facial injuries sustained from street fights. Despite common assumptions, the absence of a significant association with hospital stay or hospital charges underscores the complexity of trauma management. Moving on to the intricacies of surgical treatment for zygomatico-orbital fractures, CT assessment of 492 surgically treated zygomatico-orbital fractures in relation to the suture/s involves highlighting the increased likely need for surgical exploration in the presence of concomitant paranasal buttress fracture.
In the realm of orbital fracture management, the utilization of preformed orbital plates shows promise in restoring orbital volume, albeit with residual hypoglobus observed in a subset of patients. The innovative use of open-source software for orbital volume assessment presents a novel avenue for treatment planning and may enhance the precision of surgical interventions in orbital trauma cases.
A retrospective analysis reveals a notable shift in the method of maxillomandibular fixation over a decade, highlighting the shift from classic Erich arch bars to rapid maxillomandibular fixation. This evolution of surgical techniques highlights the importance of research in pursuit of improving patient outcomes.
In the face of increasing maxillofacial injuries due to combat trauma, highlighted by Rehman et al’s systematic review, it is crucial to underscore the importance of safe medical facilities and the protection of healthcare workers. Recent conflicts, such as those in Russia and Ukraine, and the Gaza–Israeli conflict, serve as stark reminders of the dangers faced by medical personnel and patients alike. Our hope remains steadfast: that healthcare workers can continue to provide aid to the injured, regardless of the circumstances, within secure and protected medical environments. In these challenging times, let us prioritize safety, well-being, and mutual care.
Stay safe, stay well, and take care of each other.
