Trends in Facial Fracture Repairs, 1996 to 2006

Abstract

Objective: 1) Learn how rates of operative facial fractures may have changed between 1996 and 2006. 2) Determine potential impact of such change on otolaryngology residency surgical key indicator cases. Method: The National Hospital Discharge Survey (NHDS) and National Survey of Ambulatory Surgery (NSAS) 1996 and 2006 cases were reviewed, extracting all cases of 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 ± 3,740 operative facial fracture repairs performed. Among the 3 key indicator fracture repairs most relevant to otolaryngologists, there were 15,810 ± 2,143 open nasal fracture reductions, 9,360 ± 1,742 open zygomaticomaxillary (ZMC) fracture reductions, and 20,214 ± 2,585 open mandibular fracture repairs. Overall in 2006, there were 120,463 ± 7,554 total facial fracture procedures, with 11,613 ± 2,846 open nasal fracture reductions, 10,216 ± 2,881 open ZMC fracture reductions, and 17,965 ± 3,171 open mandibular repairs. Comparing cohorts, there was no significant change in number of open nasal, ZMC, or mandibular fractures repairs ( P = .24, P = .58, P = .80, respectively). Conclusion: Despite perceptions, 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.