Samuel Lance's research while affiliated with University of California, San Diego and other places

Publications (44)

Article
Full-text available
Background This study compares the arthroscopic shaver and liposuction with other established methods for treatment of adolescent gynecomastia. Methods Surgical management was via four operative techniques: open excision, open excision/liposuction, arthroscopic shaver/liposuction, or open excision and free nipple graft. Data were collected and com...
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After the cessation of all in-person visiting rotations during the coronavirus 2019 pandemic, many programs developed virtual rotations as an alternative for the recruitment and education of prospective applicants. In this study, we developed a consortium of three institutions each with a unique virtual subinternship and prospectively surveyed part...
Article
Background: Management of nonfatal ballistic facial trauma is well described in the literature for wounds secondary to military combat. However, there is little literature describing such management in civilian practice. We aimed to describe nonmilitary patients with recent nonfatal facial injuries from ballistic trauma using the California Office...
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Background Burn injuries are common in low- and middle-income countries (LMICs) and their associated disability is tragic. This study is the first to explore burn scars in rural communities in Mozambique. This work also validated an innovate burn assessment tool, the Morphological African Scar Contractures Classification (MASCC), used to determine...
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Background: There is a paucity of data on normal intracranial volumes for healthy children during the first few years of life, when cranial growth velocity is greatest. The aim of this study was to generate a normative predictive model of intracranial volumes based on brain magnetic resonance imaging from a large sample of healthy children to serv...
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Background: Due to the recent COVID-19 pandemic, patient care and medical education have faced many significant changes. The Association of American Medical Colleges and the American Council of Academic Plastic Surgery officially recommended halting all student rotations and interviews for the year. This change has unfortunately fallen squarely at...
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Background: Surgical correction of unicoronal craniosynostosis (UCS) remains a challenging problem. Long-term results are often unsatisfactory secondary to recurrence of the original deformity, requiring secondary operations such as fat grafting or complete revision of the calvarial remodeling. Distraction osteogenesis (DO) has recently emerged as...
Article
Background: Unilateral coronal craniosynostosis (UCS) is the third most prevalent form of craniosynostosis. Traditional treatment of UCS has been achieved with fronto-orbital advancement and cranial vault remodeling (FOAR), but utilization of cranial distraction osteogenesis (DO) techniques has increased. This study aims to compare perioperative c...
Article
Once medical students attain a certain level of medical knowledge, success in residency often depends on noncognitive attributes, such as conscientiousness, empathy, and grit. These traits are significantly more difficult to assess than cognitive performance, creating a potential gap in measurement. Despite its promise, competency-based medical edu...
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Purpose of Review This review focuses on the literature from the recent conflicts in Iraq/Syria and Afghanistan as well as techniques for addressing combat related craniofacial trauma. This review also includes practical lessons, techniques, tips, and “pearls” from several military experts with operational deployment experience. Recent Findings Cr...
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Background: Unicoronal craniosynostosis is associated with orbital restriction and asymmetry. Surgical treatment aims to both correct the aesthetic deformity and prevent the development of ocular dysfunction. We used orbital quadrant and hemispheric volumetric analysis to assess orbital restriction and compare the effectiveness of distraction oste...
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Background Alveolar bone grafting is utilized to manage alveolar clefts in patients with cleft lip and palate. However, the timing of bone grafting is variable with conflicting evidence supporting the use of primary alveolar bone grafting (PABG) in clinical practice. Primary Aim To provide a qualitative systematic review analysis of long-term outc...
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Introduction: The primary outcome metric in patients with craniosynostosis are changes in intracranial volumes (ICVs). In patients who undergo distraction osteogenesis (DO) to treat craniosynostosis, changes are also dependent on the length of distraction. Virtual surgical planning (VSP) has been used to predict anticipated changes in ICV during c...
Article
Purpose: The timing and management of patients with cleft palates have been controversial. Early soft palate closure at the time of cleft lip repair followed by hard palate closure at a second stage has been hypothesized to improve speech and audiology outcomes. This study compares cleft palate patients who have undergone single-stage versus 2-sta...
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Introduction: The craniofacial asymmetry seen in unilateral lambdoid craniosynostosis may not be effectively treated by posterior cranial vault remodeling, endoscopic suturectomy, and helmet therapy, or suturectomy and distraction osteogenesis alone due to limitations in soft-tissue envelope expansion and relapse of the deformity. The authors repo...
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Background: Previous research has shown that patients with metopic craniosynostosis have significantly reduced intracranial volumes (ICVs) compared to normal healthy children. Furthermore, the metopic index (ratio of midfrontozygomatic diameter to maximal cranial width) has been described as an anthropometric cranial index for patients with metopi...
Article
Objective While adenotonsillectomy (AT) remains first line therapy for pediatric obstructive sleep apnea (OSA), management of children who are not candidates for AT or who have residual OSA post AT varies and spans across multiple specialties. We aim to report our experience in managing this population through a multidisciplinary sleep clinic compo...
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Full-text available
Objective The 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. Methods Single‐institution retrospective case series of patients presenting to a le...
Article
Surgical infiltration of liposomal bupivacaine in the adult population has been shown to decrease perioperative use of opioids, but there have been few studies conducted in the pediatric surgical population. The authors’ objective was to assess the effect of liposomal bupivacaine on opioid reduction in the pediatric alveolar cleft population. The a...
Article
Opioid use can cause significant adverse side effects with increased propensity toward both short- and long-term complications in the pediatric population. We present a multifaceted opioid reduction protocol based on physician and care team member education. The strategy was designed to alter prescribing practices, improve preoperative and postoper...
Article
Background: The impact of metopic craniosynostosis on intracranial volume (ICV) and ICV growth is unclear. In addition, the relationship between head circumference (HC) and ICV in these patients is not previously described. Methods: A retrospective review of 72 patients with metopic craniosynostosis was performed. The ICVs were calculated from m...
Chapter
Understanding the anatomy and surgical technique for repair of the unilateral and bilateral cleft lip remain essential to the practice of plastic surgery. This chapter summarizes the relevant anatomy, clinical evaluation, surgical technique, and postoperative care of the cleft lip patient. Step-by-step surgical descriptions and illustrations are pr...
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Background: The aims of the current analysis were to study the change in ventricular volume (VV) obtained with cranial distraction in patients with craniosynostosis and compare it with the change in total intracranial volume (ICV) and brain volume. Methods: After institutional review board approval, a retrospective review was performed on patien...
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Background: Calculation of intracranial volume from neuroimaging can be complex and time consuming. In the adult population, there is evidence suggesting that owing to its strong correlation, head circumference (HC) may be used as a surrogate for intracranial volume (ICV). We were interested in studying the correlation between HC and ICV in patien...
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Background: The limitations of the soft-tissue envelope, devascularized bone grafts, and relapse of the deformity are important considerations in the surgical treatment of unicoronal craniosynostosis. The authors report their technique evolution of distraction osteogenesis for treatment of patients with unicoronal craniosynostosis. Methods: Open...
Article
Reconstructive cranioplasty can be associated with many complications and add to the not insignificant potential risks associated with decompressive craniectomy. In the setting of post-traumatic hydrocephalus, treatment with a ventriculoperitoneal (VP) shunt prior to reconstructive cranioplasty likely increases these risks even further. The authors...
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Introduction: Timing of intervention and complication profiles in surgical repair of craniosynostosis have been widely debated. Early intervention is frequently promoted as a means of decreasing morbidity while maintaining favorable outcomes via minimally invasive techniques such as endoscopic strip craniectomy. Immediate postoperative morbidity d...
Article
Introduction: Methods of reporting quantitative results for distraction osteogenesis (DO) of craniosynostosis have been inconsistent. Therefore, the efficacy of differing techniques and timing in regard to volume change is not well established, with no uniform metric for comparisons. Given that cranial vault remodeling with DO may be completed wit...
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Background: Both the general and pediatric surgical literature have evidenced an inverse relationship between surgical case volume and complications. This study seeks to ascertain the relationship between case volume and fistula rates in cleft palate patients. We also seek to determine if craniofacial fellowship training impacts fistula rates. Me...
Article
Purpose/Objective In the United States over 40% of incident breast cancer diagnoses are in women over 65 years of age. Effective breast cancer treatments allow elderly patients to live long, healthy lives; questions regarding long-term quality of life are increasingly important. In women over 65, post-mastectomy breast reconstruction (PMBR) is unco...
Article
Introduction: Autologous fat grafting is a valuable tool in the correction of facial soft tissue asymmetry and volume deficits. Pubertal growth and fluctuations in body mass present unique challenges to achieving satisfactory results after autologous fat transfer in the pediatric population. Few studies exist describing the outcomes and complicati...
Article
Nablus masklike facial syndrome (NMLFS), characterized by tight, expressionless facial features resembling a mask, was first described in 2000. Since then, 10 cases have been identified with the same phenotype and genotype. Although detailed descriptions of the facial and external ear characteristics unique to the syndrome exist, no clear descripti...
Article
Introduction: Pansynostosis can result in markedly thin calvarial bone resulting in poor quality and quantity of allograft for cranial vault expansion. Such scenarios can result in large calvarial defects and poorly stabilized constructs. Additionally, the osteoinductive properties of neonatal dura and paracranium in cranial vault reconstruction s...
Article
The use of negative-pressure wound therapy (NPWT) for management of open wounds and immobilization of split-thickness skin grafts (STSGs) over wounds has been well described. However, there is a concern for potential compromise of flap viability when NPWT is used for skin grafts over pedicled muscle flaps. We have used NPWT to immobilize STSGs in e...

Citations

... 2,3 Patients presenting with unicoronal synostosis are characterized by ipsilateral frontal flattening, superior orbital rim displacement, and palpebral fissure widening, with more severe cases affecting the contralateral skull. [3][4][5] Management of unicoronal craniosynostosis must take into account the dysmorphology resulting in asymmetry of the face and cranium. 6,7 Primary reconstruction aims to restore symmetry, prevent intracranial hypertension, resolve cephalocranial disproportion, and facilitate normal skull growth for the developing brain. ...
... Emotional stability and openness-as defined by the Big 5 Personality Test-were also related to lower burnout in students during their clerkship years (40). Further, non-cognitive capacities were recently investigated to determine their predictive validity for learners, educators, and institutions, and thereby broaden the value of their application (41). This study's findings regarding perseverance could be valuable in this perspective. ...
... Unilateral coronal synostosis (UCS) constitutes ~10% of all incidences of craniosynostosis and primarily causes ipsilateral retrusion and contralateral bulging of the forehead (1). Additionally, UCS can lead to complex secondary deformities that comprise facial asymmetries with deviation of the nose toward the affected side, orbit dystopia, zygomatic asymmetries, and possible effects involving dental occlusion (2)(3)(4)(5)(6)(7). The functional consequences of UCS can include strabismus, amblyopia and astigmatism, and increased intracranial pressure (8-11). ...
... This timing is defined as primary ABG. However, detrimental effects on craniofacial growth have been reported and the procedure has practically been abandoned worldwide [1,2]. When ABG is carried out after the cleft lip and palate have been repaired, it is defined as secondary ABG. ...
... 4860 (53%) patients. Two studies explicitly mentioned to not have used objective VPI assessment and in the remaining studies it was not described (Table 9) [29,30]. The threshold for performing SCS was not mentioned in a quantifiable way. ...
... 8,9 Moreover, radical calvarial remodeling techniques show positive results but incomplete normalization. 5,[10][11][12] Remodeling the posterior skull vault is technically challenging due to surgical difficulties with this area of the skull. Furthermore, there is a significant risk of posterior relapse from postural forces when the patient is placed "back to sleep," which will affect any fixation material after CVR. 13 The use of 3-dimensional (3D) CT has provided valuable information regarding planning and treatment evaluation. ...
... Earlier surgical interventions have been shown to be associated with better neurocognitive scores in children with sagittal synostosis [4] and may also be an important factor for long-term outcomes in metopic synostosis. Previous studies have demonstrated [15,27]. Later surgeries may increase the duration of compression on the frontal lobe, further impacting development in visuomotor integration and long-term executive functioning. ...
... Previous MDCs have focused on care coordination; however, their target populations, locations, and structures varied substantially [12][13][14][20][21][22]. Moreover, few studies have utilized caregiver and patient satisfaction as an outcome. ...
... Other specialties, including urology, geriatric medicine, plastic surgery, ophthalmology, and pathology, as well as other surgical subspecialties, have created novel curricula catered toward medical students and residents in a time when educational gaps were created by pandemic restrictions. [7][8][9][10][11] For example, during the onset of the COVID-19 pandemic in 2020, urologists across the country adopted web-based platforms to develop a virtual lecture series to fill the gap in in-person education. 7 The American Urological Association (AUA) offers resources to students, residents, and practicing urologists to study a wide array of topics in the field, much like the ASA. ...
... Powered scooters and electric bicycle-related injuries include soft tissue injuries and fractures 8 . As for ocular injuries, eyelid injuries are the third most frequently sustained soft tissue injury, and orbital fractures are the most common osseous injuries 9 . Lateral orbital rim and floor fractures have been found to have the highest prevalence, followed by orbital roof and medial wall fractures. ...