About Sam P. Most, MD
Evidence-based medicine in Facial Plastic Surgery
The primary goal of this research program is to develop a higher standard of care for facial plastic surgery patients. The approach to this goal is two-fold. The first involves development of prospective studies that examine the efficacy of new or existing surgical techniques in facial plastic surgery. One clinical problem we have already begun to examine is nasal obstruction. Functional rhinoplasty techniques have been a mainstay of otolaryngology, and facial plastic surgery in particular, for decades. While many have attempted, with mixed success, to examine nasal function using quantitative measures, few prospective studies of quality of life have been performed. To this end, we have begun to examine prospectively various functional rhinoplasty techniques.
The second approach to development of a higher standard of care for our patients is the testing of various over-the-counter ‘cosmeceutical’ products. Generally, products that are touted as effective by industry have little or no clinical evidence to back up said claims. Two of these studies have been completed and have resulted in remarkable response from industry as well as the media 4,. More importantly, these types of studies provide valuable information about product efficacy to physicians and patients alike.
Facial Nerve Recovery After Injury
Facial nerve injury after trauma or extirpative surgery can be devastating to patients. The Division seeks to develop a clinical and basic research program studying facial nerve recovery after such injuries. The basic research program within the Division will use a previously developed animal (mouse) model for facial nerve injury to examine the age-dependence of motor neuron survival in the facial nucleus and its correlation to facial nerve recovery. Furthermore, the role of apoptotic cell death in the facial nerve nucleus will be studied, with the hope that anti-apoptotic processes may aid in facial nerve recovery. The clinical research program will study quality of life issues in facial nerve injury patients.
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Figure legends:
Figure 1: Anterior septal reconstruction, a modified extracorporeal septoplasty technique.
Figure 2: A) Murine facial nerve nucleus (outlined with arrowheads); B) Facial motor neurons stained with anti-bcl2 antibody (arrows).
