OMFS programs with high nerve repair volume

[ilikeur3rds]

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I’m currently putting together all the programs that I want to apply to for residency and it seems like a lot advertise “microneurosurgery” as an aspect of their training program, but I was just curious if any one knows of programs that actually do nerve repairs at a high volume?

 

[deleted923283]

Each of our Chiefs at Case do a couple every year. I think Ziccardi at Rutgers does a decent amount.

I assume you mean IAN and Lingual nerve repairs. There are guys who do facial nerve stuff, but it’s almost always specialized ENT guys.

 

[DocMon16]

I did a couple cases at Monte but we aren’t doing them weekly. Rutgers does a decent amount.

 

[Jaa_]

Northwell does a lot. In addition to repairs, we also do a lot of IAN reconstruction with our segmental mandibulectomy cases (usually in conjunction with a fibula).

A large volume of nerve injuries from NYC/LI come to us.

 

[nade0016]

Interesting thread. Not sure I would use IAN repair as a guide for choosing a residency. Very rare procedure nationwide.....unless your program operates on some that might not need the procedure for MRB. Looking back, if I was an applicant now I would look for 5 things in this order.

1. Culture
2. Case volume
3. Staff levels and involvement
4. Call experiences and trauma experience
5. Autonomy of senior level residents

I can tell you that there are programs where chief residents assist and do not operate. This is not common but more frequent that it should be. Can you imagine if a general surgery or OB program only allowed the chief residents to assist. ACGME would shut those programs down in a year but here with CODA we let that slide.

 

[ParklandOMFS]

We do a decent bit here at Parkland with Dr Zuniga - he is dual appointed in neurology and has a PhD in neuroscience.

In total we did about 150 last year per our CODA numbers, but this also includes repairs after composite or segmental resections, etc.

As it was mentioned above, it is fairly rare to have a IAN or lingual nerve injury that goes to the OR.

 

[Masterus]

At UAB, a lot of the fibulas get a nerve recon especially the benign resections. The 5th year or 6th year are left completely alone at the head to repair the nerve after resection because they’re still raising the fibula. I did about 8 solo as a 5th year. You really only need to do like a few alone and you probably will never want to touch it again 😂 The head and neck service is pretty busy and these “smaller procedures” of the day, residents always get their hands busy with. We do them outside of this infrequently but like I said that’s really all you need to get the experience of putting an axogen nerve with connector on with a 6-0 or 8-0 nylon. Highly recommend wearing loupes.

If you have questions about the program, feel free to DM me.

 

[deleted1196239]

I think Dr Zuniga at Parkland and Dr Miloro at UIC do the most and published the most in this field.

Honestly, if you are trained in a big broad scope program, nerve repair using axogen allograft is not a difficult surgery

 

[deleted923283]

I think Dr Zuniga at Parkland and Dr Miloro at UIC do the most and published the most in this field.

Honestly, if you are trained in a big broad scope program, nerve repair using axogen allograft is not a difficult surgery

Yeah, I think most major programs are doing Axogen allografts now.