Contemporary Trends in Procedural Volume for Adult Facial Trauma, 1996-2006

Objectives. To determine how rates of operative facial fractures may have changed between 1996 and 2006 and to determine the potential impact of such change on otolaryngology residency surgical key indicator cases. Study Design. Historical cohort study. Setting. Academic medical center. Subjects and Methods. The National Hospital Discharge Survey (NHDS) and National Survey of Ambulatory Surgery (NSAS) 1996 and 2006 cases were reviewed, extracting all cases of adult nasal, malar/zygomatic, maxillary, and mandibular fracture reductions in inpatient and outpatient settings, respectively. Procedure rates for each facial fracture were tabulated and compared between 1996 and 2006. Results. Overall in 1996, there were an estimated 113,041 +/- 3740 operative facial fracture repairs performed. Among the 3 key indicator fracture repairs most relevant to otolaryngologists, there were 15,810 +/- 2143 open nasal fracture reductions, 9360 +/- 1742 open zygomaticomaxillary (ZMC) fracture reductions, and 20,214 +/- 2585 open mandibular fracture repairs. Overall in 2006, there were 120,463 +/- 7554 total facial fracture procedures, with 11,613 +/- 2846 open nasal fracture reductions, 10,216 +/- 2881 open ZMC fracture reductions, and 17,965 +/- 3171 open mandibular repairs. Comparing cohorts, there was no significant change in number of open nasal, ZMC, or mandibular fracture repairs (P = .24, P = .58, P = .80, respectively). Conclusion. Facial fracture procedure rates have remained largely stable over the past 10 years. These data have implications for otolaryngology training programs and could help guide resident education in facial trauma.