One of the main missions of the academic surgeon is to teach residents, pass on the knowledge, and build a strong generation of young otolaryngologists. Our team has been dedicated to building a strong residency program that exposes residents to all aspects of otolaryngology-head and Neck surgery, and prepares them to successfully sit and pass the American Board Examination (ABOHNS). This round table will discuss the challenges and key concepts to building a well rounded training program in Otolaryngology. It will include surgeons and leaders from the United-States and Europe. We will specifically discuss the topics of funding, recruiting, mentorship, research activities, and teaching in a learner-centered environment.

Introduction: Facial paralysis negatively impacts patients’ physical, psychological, and social well-being. Optimal care requires a multidisciplinary approach involving specialists in neurotology, facial plastic surgery, neurosurgery, neuroradiology, physical therapy, ophthalmology, and neurology.

However, standardized collaborative pathways remain underdeveloped and underutilized. This study evaluates the outcomes of an algorithm used at our facial paralysis program.

Material & Methods: A retrospective review of all patients with facial palsy since March, 2023 until now. The group included both pediatric and adult patients.

Results: Fifty-three patients have been seen by our clinicians. Etiology of palsy included temporal bone fractures and other types of trauma, post-surgical, viral (e.g,, Bell's palsy and Ramsay Hunt syndrome), tumors (benign and malignant). Patients underwent facial nerve decompression and grafting as well as chemodenervation, selective myectomy, selective neurectomy, static and dynamic slings, facial nerve transfers, and muscle transfers (both pedicled and free flaps). All patients also underwent physiotherapy. A physical therapy evaluation form was created. Data collection has been initiated utilizing multiple outcome measures to demonstrate effectiveness of treatment. The current evaluation utilizes the House-Brackmann and Sunnybrook Grading Scales, the Facial Disability Index, the Synkinesis Assessment Questionnaire and the CORE 10. These measures look at both the physical and mental health impairments associated with facial nerve palsy.

Conclusions: A structured multidisciplinary model for facial paralysis management enhances functional recovery, aesthetic outcomes, and patient quality of life. Early referral and coordinated interdisciplinary care are critical determinants of success.

Experts in our field have previously issued guidelines to optimize the safety of filler injections. Despite the risks, a growing online trend of at-home self-injection of fillers in the face is putting patients in danger. We present our experience treating acute vascular injury in the United States. Based on the most recent literature, we share our protocol and its efficacy for this specific case. The fast-growing popularity of fillers in the beauty industry, and the availability of online content and videos on how to perform self-injections, likely give a false sense of safety to patients. Physician awareness is essential to prevent serious complications in our patient population. A strong knowledge of facial anatomy, the use of FDA approved products, and having the procedure performed by a trained medical professional are key elements to successful and safe filler injection.

filler complications round table discussions