How has the COVID Pandemic Impacted the Clinical Volume and Variety of an Academic Oral and Maxillofacial Surgery Program?

PURPOSE: Attempts to mitigate the coronavirus disease of 2019 (COVID) have disrupted the delivery of non-pandemic care. The purpose of this study was to evaluate the effects of the COVID pandemic on surgical volume and variety at an academic oral and maxillofacial surgery program. MATERIALS AND METHODS: A retrospective cohort study was conducted using the surgical logs of the University of Pennsylvania, Department of Oral and Maxillofacial Surgery from January 2012 through January 2021. Each record identified patient demographics and case classifications. The study predictor was timing of care, which was divided into pre-pandemic, peak pandemic, or post-peak pandemic. The primary study outcomes were the monthly procedure count and the procedure categories. The secondary dependent variables were patient age and race. Multivariate and univariate analyses of variance were used to determine whether pandemic effects existed within outcome groups. RESULTS: The final sample included 64,709 surgical procedures. Before, during, and after the pandemic peak, there were means of 691.0, 209.0, and 789.4 procedures per time period, respectively (P < .01). There was significantly more infection (baseline 2.2%, peak 6.0%, post-peak 2.0%, P < .01) and trauma (baseline 5.3%, peak 26.7%, post-peak 3.9%, P < .01) cases during the pandemic peak. The mean percentage of pediatric patients increased during the peak and post-peak periods (baseline 2.4%, peak 12.9%, post-peak 10.2%, P < .01). No differences were observed among the mean percentage of White (P = .12), Black (P = .21), and Hispanic (P = .25) patients treated. CONCLUSIONS: Along with a predictable decline in surgical numbers, a greater proportion of infection and trauma procedures were performed at the pandemic's peak. Despite these changes, surgery volume normalized and case variety returned to pre-pandemic levels in the post-peak period. Our study suggests that the addition of COVID restrictions did not change the case volume or variety in the months' after the initial crisis.

Epidemiologic Patterns of Maxillofacial Trauma in a Metropolitan Area: A Retrospective Analysis.

PURPOSE: To illuminate epidemiologic trends of maxillofacial trauma in an urban setting over an 11-year period. MATERIALS AND METHODS: We performed an exhaustive database search at the University of Pennsylvania. The data were collected from 11 years of attending oral and maxillofacial surgery clinician and resident operating room logs and was conducted from 2011 to 2021. The procedures where then selected for those that represented maxillofacial trauma. RESULTS: About 3,427 procedures met the inclusion and exclusion criteria to be considered a novel incidence of trauma. Dramatic differences in maxillofacial trauma exist between time of the year, patient age, and patient race. There is a correlation between summer time criminal activity and maxillofacial trauma. African-Americans ages 18 to 65 are the most affected patient demographic. CONCLUSIONS: With datasets of this size spanning over a decade, epidemiologic trends are able to be illuminated. There is a need for understanding the disparity between the demographics of the Philadelphia population and oral-maxillofacial (OM) trauma patients. A prospective extension of this study is to explore secondary, tertiary and quaternary ICD-10 codes to illuminate common injury patterns in OM trauma of varying patient populations.

Do Mandatory Face Shields Reduce the Number of Craniomaxillofacial Injuries in the National Hockey League?

PURPOSE: The purpose of this study was to analyze the effectiveness of the National Hockey League's (NHL) mandatory visor policy on the number and type of craniomaxillofacial (CMF) injuries. MATERIALS AND METHODS: A cross-sectional study was designed using the 2 databases: the NHL Injury Viz and the Pro Sports Transactions. CMF injuries and player characteristics from the NHL's 2009-2010 through the 2016-2017 seasons were obtained. The study outcomes of games missed and number of injuries were compared before and after the implementation of the league rule. RESULTS: A total of 149 CMF injuries were included in the final sample. Following the mandatory visor rule, there were significant decreases in the total number of CMF injuries per season (14.3 vs 30.7, P = .01) and the number of upper face injuries per season (7.0 vs 16.7, P = .04). Although there was no difference in the ratio of upper facial injuries before and after the rule change, players who wore a face shield did have a lower proportion of upper face injuries among all CMF injuries sustained (42.9 vs 64.6%, P < .01). Ultimately, neither face shield use (P = .49) nor implementing a mandatory face shield rule (P = .62) changed the number of games missed when injury did occur. CONCLUSIONS: Upper facial injuries were observed to be less common among players wearing face shields. After the NHL mandated face shields, there were significant decreases in the mean number of CMF and upper facial injuries per season. Face shields did not appear to influence the severity or downtime from injury that were sustained.