Does Surgical Specialty Impact Mandibular Fracture Outcomes?

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Outcomes Research

Background:

• Maxillofacial trauma management involves both plastic surgery (PRS) and otolaryngology (ENT) specialists.
• Existing differences in training and practice patterns between PRS and ENT have not been evaluated regarding patient outcomes.

Purpose of the Study:

• To compare the perioperative outcomes of mandible fracture management between plastic surgery and otolaryngology specialists.
• To determine if differences in specialty training impact patient outcomes for maxillofacial trauma.

Main Methods:

• A retrospective review of mandible fracture cases from the National Surgical Quality Improvement Program (NSQIP) database (2005-2016).
• Comparison of demographic variables, repair types, and adverse outcomes between PRS and ENT managed patients.
• Analysis included 1,282 cases, with 756 managed by ENT and 526 by PRS.

Main Results:

• No statistically significant differences in 30-day readmission, reoperation, or wound infection rates were observed between PRS and ENT.
• While patient demographics were similar, ENT managed a higher proportion of high ASA class patients, and PRS managed more dirty/infected wounds.
• Length of stay was significantly longer for PRS patients (2.0 days) compared to ENT patients (1.3 days).

Conclusions:

• Both plastic surgery and otolaryngology provide comparable perioperative outcomes for mandible fracture management.
• Despite variations in training, neither specialty demonstrates superior results in terms of key adverse events.
• These findings support the efficacy of both PRS and ENT in treating mandible fractures.