ObjectiveThe use of standing electronic scooters associated with micromobility applications (e‐scooters) has risen nationally. The aim of this study was to obtain a detailed view of soft tissue and bony craniofacial injury associated with e‐scooter‐related trauma.MethodsSingle‐institution retrospective case series of patients presenting to a level 1 trauma center emergency department or trauma unit with documented e‐scooter‐related craniofacial injury.ResultsOf 203 included patients, 188 (92.6%) patients sustained craniofacial injury. One hundred thirty‐one (64.5%) had exclusively soft tissue injury, 3 (1.5%) exclusively bony injury, 51 (25.1%) both soft and bony injuries, and twenty‐five (12.3%) patients sustained dental injury. Aesthetic units most frequently sustaining acute soft tissue injury were the forehead (n = 106, 34.6%), scalp (n = 36, 11.8%), chin (n = 34, 11.1%), upper lip (n = 32, 10.5%), and cheek (n = 31, 10.1%). Aesthetic subunits most often sustaining acute soft tissue injury included the brow (42, 13.7%), central forehead (39, 12.7%), lateral forehead (n = 25, 8.2%), and upper lip vermillion (n = 23, 7.5%). Craniofacial osseous fracture most often occurred in the orbit (n = 42, 24.6%) and maxilla (n = 40, 23.4%). Individual osseous segments most frequently sustaining acute fracture included the anterior maxillary sinus wall (n = 22, 12.9%), nasal bone (n = 20, 11.7%), lateral orbital wall (n = 16, 9.4%), orbital floor (n = 15, 8.8%), and zygomatic bone (13, 7.6%).ConclusionsOur analysis demonstrates that most patients presenting to our center with craniofacial trauma sustained acute bony fracture, most often to the midface. Our data of common injuries associated with e‐scooter trauma could inform implementation in the form of facial safety equipment or safety skills training for e‐scooter riders.Level of evidence4

4.

Objective: To identify predictors of near dehiscence (ND) or thin rather than dehiscent bone overlying the superior semicircular canal in patients with signs and symptoms suggestive of superior semicircular canal dehiscence syndrome (SCDS), as well as post-operative outcomes. Study Design: Retrospective case-control study Setting: Tertiary referral centerPatients: All 288 patients who underwent middle cranial fossa approach for repair of SCDS were reviewed for cases of ND. Demographics, symptoms and clinical signs including nystagmus, ocular vestibular-evoked myogenic potential (oVEMP) amplitude, cervical vestibular-evoked myogenic potential (cVEMP) thresholds, and low frequency air-bone gap (ABG) were compared before and after surgery.Main outcome measure: Presence of pre-operative ND and post-operative symptoms and physiologic measures.Results: Seventeen cases of ND (16 patients, 17 ears) and 34 cases (34 ears) of frank SCDS were identified. ND cases differed from frank dehiscence cases in that they were less likely to have nystagmus in response to ear canal pressure or loud sounds, OR=0.

Purpose Elevated glycosylated hemoglobin (HbA1c) is often found in surgical patients with no history of diabetes. The purpose of this prospective observational study was to determine if elevated preoperative HbA1c is associated with postoperative hyperglycemia in non-diabetic surgical patients and to identify predictors of elevated HbA1c. Methods This study included 257 non-diabetic adults scheduled for inpatient surgery. Preoperatively, capillary blood glucose (CBG) and HbA1c were measured and patients completed the Canadian Diabetes Risk Questionnaire (CANRISK). Capillary blood glucose was measured for two days or until hospital discharge at the following time points: postoperatively, before all meals, and at 22:00 hr. The mean CBG and incidence of hyperglycemia were compared between HbA1c levels: Group I \ 6.0%, Group II 6.0-6.4%, and Group III C 6.5%. ResultsThe mean postoperative glucose levels at all time points were significantly higher in Group III compared with Groups I and II (P \ 0.01). At least one episode of hyperglycemia (CBG C 10.0 mMolÁL -1 ) occurred in 61% (11/18) of patients in Group III vs 11% (23/209) of patients in Group I (relative risk, 5.55; 95% confidence interval [CI], 3.26 to 9.47; P \ 0.001). Elevated glycosylated hemoglobin C 6.0% was found in 31% (33/107) of those with a high CANRISK score. The best predictors of postoperative hyperglycemia were preoperative CBG [ 6.9 mMolÁL -1 [diagnostic odds ratio (OR) (reference\6.0 mMolÁL -1 ), 4.16; 95% CI, 1.57 to 10.98; P = 0.004], HbA1c C 6.0% [OR (reference \ 6.0%), 3.00; 95% CI, 1.39 to 6.49; P = 0.005], and HbA1c C 6.5% [OR (reference \ 6.5%), 13.45; 95% CI, 4.78 to 37.84; P \0.001]. Conclusions Elevated HbA1c is associated with higher mean postoperative glucose levels in patients with no diabetic history. The CANRISK score is a strong predictor of elevated HbA1c, while CBG and HbA1c are both predictors of postoperative hyperglycemia. RésuméObjectif Une hémoglobine glycosylée (HbA1c) élevée est souvent observée chez des patients chirurgicaux sans antécédents de diabète. L'objectif de cette étude observationnelle prospective était de déterminer si une HbA1c préopératoire élevée est associée à une hyperglycémie post opératoire chez des patients chirurgicaux non diabétiques et d'identifier les facteurs prédictifs d'une HbA1c élevée. Méthodes Cette étude a inclus 257 adultes non diabétiques devant être hospitalisés pour chirurgie. La glycémie capillaire (CBG) et l'HbA1c ont été mesurées en

Maxillomandibular fixation with autologous cartilage graft is an effective management strategy for complications of canalplasty resulting in exposure of the temporomandibular joint capsule and surgical emphysema.