Emergency Route Research Articles

Bilateral Sphenopalatine Artery Embolization in A Low-Energy Facial Trauma: Case Report and Literature Review

Epistaxis is very frequented emergency faced by ENT practician around the world, commonly benign but can lead to dangerous morbidities if refractory. Surgical is the standard treatment and embolization and endoscopic ligation are the emergent routes of treatment constituting the main arsenal to face refractory epistaxis with similar success rate. We thus report a low energy-traumatic bilateral refractory posterior epistaxis treated with arterial embolization with no rebleeding up to 6-monthmarque follow-up.

Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients' Referral Routes.

Head and neck cancers (HNC) are often late stage at diagnosis; stage is a major determinant of prognosis. The urgent cancer referral pathway (two week wait; 2WW) within England's National Health Service aims to reduce time to diagnosis. We investigated factors associated with HNC route to diagnosis. Data were obtained from the English population-based cancer registry on 66,411 primary invasive HNCs (ICD C01-14 and C31-32) diagnosed 2006-2014. Multivariable logistic regression determined the likelihood of different diagnosis routes by patients' demographic and clinical characteristics. Significant socio-demographic inequalities were observed. Emergency presentations declined over time and 2WW increased. Significant socio-demographic inequalities were observed. Non-white patients, aged over 65, residing in urban areas with advanced disease, were more likely to have emergency presentations. White males aged 55 and older with an oropharynx cancer were more likely to be diagnosed via 2WW. Higher levels of deprivation were associated with both emergency and 2WW routes. Dental referral was more likely in women, with oral cancers and lower stage disease. Despite the decline over time in emergency presentation and the increased use of 2WW, socio-demographic variation is evident in routes to diagnosis. Further work exploring the reasons for these inequalities, and the consequences for patients' care and outcomes, is urgently required.

Emergency Management in Building Based On 3D BIM and GIS Technology

An emergency route is a route designed for human use to save themselves from dangerous situations. However, if it is considered trivial, this has unknowingly led to an increase in accidents. The provision of emergency routes on a community scale in indoor areas in terms of time is rarely discussed in emergency evacuation studies. This study aims to investigate the emergency route in the building due to the environmental factors of the closed area and the arrangement of office equipment. The method of this study is divided into two sub-sections, namely data preparation and data analysis process. Demographic data and physical interactions were used as the selection of walking speed criteria while the use of geometric data to see the actual plan route position of the building. 3D building models are built through Revit software and then converted to industry foundation classes format (.IFC) and then to multipatch shapefile (.shp) to be integrated into ArcGIS software. This is intended for the use of the data analysis process that is to build a geometric network model (GNM). GNM is designed to determine the safest and shortest routes by taking into account a variety of obstacles based on the scenario conditions. The findings shows that the evacuation time is influenced by the speed and distance of the route. 80% of the safest route selection takes a long time compared to the shortest route, while 20% is the same distance and time for the shortest and safest route because route selection is the same. The findings able to be used as a reference and guideline to determine the selection of emergency routes, especially in complex buildings.

Mediating Effects of Diagnostic Route on the Comorbidity Gap in Survival of Patients with Diffuse Large B-Cell or Follicular Lymphoma in England.

Simple SummaryThere are inequalities in cancer survival between patients with or without comorbidities. The healthcare pathway (i.e., diagnostic route) of a patient is thought to explain some of these inequalities. We explore how much of the effect of comorbidity on survival of patients with diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) is explained by the diagnostic route (i.e., emergency diagnosis). We used mediation analysis to separate the effect of comorbidity on survival from its effect through diagnostic route. We found that, for DLBCL and FL, emergency diagnosis accounted for 24% and 16% of the inequalities in survival between comorbidity groups within 12 months since cancer diagnosis. This proportion reduced over time and was small after 5 years of follow up. Comorbidities can complicate the diagnosis and management of patients with DLBCL or FL. Our results show that greater research is needed to ensure patients with comorbidities have a timely diagnosis and will help to reduce the inequalities in cancer survival.Background: Socioeconomic inequalities in survival from non-Hodgkin lymphoma persist. Comorbidities are more prevalent amongst those in more deprived areas and are associated with diagnostic delay (emergency diagnostic route), which is also associated with poorer survival probability. We aimed to describe the effect of comorbidity on the probability of death mediated by diagnostic route (emergency vs. elective route) amongst patients with diffuse large B-cell (DLBCL) or follicular lymphoma (FL). Methods: We linked the English population-based cancer registry and hospital admission records (2005–2013) of patients aged 45–99 years. We decomposed the effect of comorbidity on survival into an indirect effect acting through diagnostic route and a direct effect not mediated by diagnostic route. Furthermore, we estimated the proportion of the comorbidity effect on survival mediated by diagnostic route. Results: For both DLBCL (n = 27,379) and FL (n = 14,043), those with any comorbidity, or living in more deprived areas, were more likely to experience diagnostic delay and poorer survival. The indirect effect of comorbidity on mortality through diagnostic route was highest at 12 months since diagnosis (DLBCL: Odds Ratio 1.10 [95% CI 1.07–1.13], FL: OR 1.09 [95% CI 1.04–1.14]). Within the first 12 months since diagnosis, emergency diagnostic route accounted for 24% (95% CI 17.5–29.5) and 16% (95% CI 6.0–25.6) of the comorbidity effect on mortality, for DLBCL and FL, respectively. Conclusion: Efforts to reduce diagnostic delay (emergency diagnosis) amongst patients with comorbidity would reduce inequalities in DLBCL and FL survival by 24% and 16%, respectively. Further public health programs and interventions are needed to reduce diagnostic delay amongst lymphoma patients with comorbidities.

Emergency Route Planning with the Shortest Path Methods: Static and Dynamic Obstacles

Emergency Route Planning with the Shortest Path Methods: Static and Dynamic Obstacles

RWD69 The Impact of COVID-19 on Colorectal Cancer Screening in Northern Ireland

In Northern Ireland (NI), approximately 1,200 patients are diagnosed annually with colorectal cancer (CRC), with around 420 deaths annually making it the second highest cause of cancer-related deaths. The highest survival rate is for patients diagnosed via screening (94.1%), and lowest for those diagnosed via an emergency route (37.9%). Diagnosis requires a colonoscopy. Due to the impact of COVID-19, faecal immunochemical test (FIT) symptomatic triage was implemented in NI. This research aims to explore the rate of cancer from colonoscopies (cancer conversion rate).

Ethnic inequalities in routes to diagnosis of cancer: a population-based UK cohort study

BackgroundUK Asian and Black ethnic groups have poorer outcomes for some cancers and are less likely to report a positive care experience than their White counterparts. This study investigated ethnic differences in the route to diagnosis (RTD) to identify areas in patients' cancer journeys where inequalities lie, and targeted intervention might have optimum impact.MethodsWe analysed data of 243,825 patients with 10 cancers (2006–2016) from the RTD project linked to primary care data. Crude and adjusted proportions of patients diagnosed via six routes (emergency, elective GP referral, two-week wait (2WW), screen-detected, hospital, and Other routes) were calculated by ethnicity. Adjusted odds ratios (including two-way interactions between cancer and age, sex, IMD, and ethnicity) determined cancer-specific differences in RTD by ethnicity.ResultsAcross the 10 cancers studied, most patients were diagnosed via 2WW (36.4%), elective GP referral (23.2%), emergency (18.2%), hospital routes (10.3%), and screening (8.61%). Patients of Other ethnic group had the highest proportion of diagnosis via the emergency route, followed by White patients. Asian and Black group were more likely to be GP-referred, with the Black and Mixed groups also more likely to follow the 2WW route. However, there were notable cancer-specific differences in the RTD by ethnicity.ConclusionOur findings suggest that, where inequalities exist, the adverse cancer outcomes among Asian and Black patients are unlikely to be arising solely from a poorer diagnostic process.

RPL Based Emergency Routing Protocol for Smart Buildings

The IPv6 routing protocol for low-power and lossy networks (RPL) is a routing protocol widely used for internet of things (IoT). However, there is no RPL-based routing protocol designed for real-time effective routing in a fire incident scenario. The characteristics of sensor networks in a fire incident are that sensors or IoT devices are continuously broken, which varies the graph in RPL continuously. Therefore, this study proposes an emergency RPL (EMRPL), which can predict the trajectory of fire effectively and transmit sensing data during a fire incident in real-time. Compared with RPL, EMRPL can effectively increase the packet delivery ratio. This shows that EMRPL has higher efficiency and can be effectively applied to fire incidents.

PEDTARA: Priority-Based Energy Efficient, Delay and Temperature Aware Routing Algorithm Using Multi-Objective Genetic Chaotic Spider Monkey Optimization for Critical Data Transmission in WBANs

Software-Defined Wireless Body Area Network (WBAN)s have gained significance in emergency healthcare applications for remote patients. Prioritization of healthcare data traffic has a high influence on the congestion and delay in the WBAN routing process. Currently, the energy constraints, packet loss, retransmission delay and increased sensor heat are pivotal research challenges in WBAN. These challenges also degrade the network lifetime and create serious issues for critical health data transmission. In this context, a Priority-based Energy-efficient, Delay and Temperature Aware Routing Algorithm (PEDTARA) is presented in this paper using a hybrid optimization algorithm of Multi-objective Genetic Chaotic Spider Monkey Optimization (MGCSMO). This proposed optimized routing algorithm is designed by incorporating the benefits of chaotic and genetic operators to the position updating function of enhanced Spider Monkey Optimization. For the prioritized routing process, initially, the patient data transmission in the WBAN is categorized into normal, on-demand and emergency data transmissions. Each category is ensured with efficient routing using the three different strategies of the suggested PEDTARA. PEDTARA performs optimal shortest path routing for normal data, energy-efficient emergency routing for high priority critical data and faster but priority verified routing for on-demand data. Thus, the proposed PEDTARA ensures energy-efficient, congestion-controlled and delay and temperature aware routing at any given period of health monitoring. Experiments were performed over a high-performance simulation scenario and the evaluation results showed that the proposed PEDTARA performs efficient routing better than the traditional approaches in terms of energy, temperature, delay, congestion and network lifetime.

Stability and bifurcations analysis in an ecoepidemic system with prey group defense and two infectious routes

In this paper, we explore an ecoepidemic model of a prey–predator type in which the prey population is infected by an SI type disease with two infectious routes (horizontal and vertical). Specifically, we consider that both susceptible and infected preys have emergent carrying capacities, which implies that both preys are involved in intraspecific and interclass competitions. In addition, we assume that the susceptible prey gathers together to defend the predator. It is found that the proposed system exhibits abundant dynamics and admits nine equilibria: three boundary equilibria, three plane equilibria, and three interior equilibria. At least one of the three populations can be eliminated from the ecosystem based on the stability of the previous two types of equilibria. According to the stability of the interior equilibria, the given ecosystem can allow the coexistence of susceptible prey–infected prey–predator. We then investigate the stability and direction of Hopf bifurcation. A sensitivity analysis is also conducted to show the effects of the six parameters which are relevant to the emergent carrying capacity and infectious routes on the studied system. Numerical simulations are conducted to verify our theoretical conclusions.

Disparities and Poor Outcomes for Patients Diagnosed with Lung Cancer Through the Emergency Department

Background and Hypothesis: Cancer is currently the second leading cause of death in the United States, with lung cancer being the leading cause of cancer death. Approximately 40% of patients with lung cancer are diagnosed emergently, many at advanced stages, and occur despite the existence of lung cancer screening. However, local trends among Eskenazi Health patients are unknown. We hypothesize that individuals diagnosed with lung cancer through emergency presentations at Eskenazi Health will experience greater negative outcomes than individuals who are diagnosed through elective routes.
 Experimental Design of Project Methods: This is a retrospective chart review utilizing the Eskenazi Health electronic medical health records system. Patients with an ICD-coded lung cancer diagnosis within the five-year period between 2016 and 2021 were analyzed. We compared characteristics, health care utilization, and outcomes for adult patients who had a diagnosis of lung cancer. Our primary outcome was the number of patients diagnosed with lung cancer emergently.
 Results: Thus far, 74% of the cases viewed have been considered emergent diagnoses of lung cancer. Of the total cases, 54% of emergent diagnoses and 32% of non-emergent are stage IV. Mortality rates of both stage IV groups respectively are 74% and 62.5%. Overall mortality rates were 56.6%, and 45.9% for emergent and non-emergent diagnoses respectively. Amongst the diagnoses viewed, 93.8% failed to occur due to lung cancer screening. Rates of screening amongst the emergent group were lower at 6.6%, as opposed to non-emergent cases at 24%. 
 Conclusion and Potential Impact: A significant portion of lung cancer diagnoses at Eskenazi Health are taking place due to presentation through emergent routes. The stage of these diagnoses suggests possible missed opportunities for earlier diagnosis. Additionally, a large part of the patient population currently qualifies for lung cancer screening despite low rates of screening being performed. Future work should emphasize reducing the number of patients emergently diagnosed with lung cancer.

Method for Fast Map Construction Based on GPS Data and Compressed Grid Algorithm

Electronic maps play an important role in the field of urban traffic management, but the interface functions provided by map service agencies are limited, and commercial maps are generally expensive. Furthermore, the map generation algorithms based on the Global Positioning System (GPS) data can be very complex and take up a lot of storage space, which limits their application to specific practical problems, such as the real-time update of area maps, temporary road control, emergency route planning, and other scenarios. In order to solve this problem, an intuitive, extensible, and flexible method of constructing urban road maps is proposed. Using the Othello-coordinated method, the representation of the unit grid cell was redesigned. Through this method, the disadvantages of the raster map’s large storage space and computing resource requirements are compensated for during processing, improving the topological expression ability of the raster map and the speed with which the construction of the map is realized. The application potential of the proposed method is demonstrated by the evaluation of public transport service and road network resilience. In our experiments, the optimization efficiency of storage space was up to 99.914%, and the calculation accuracy of bus coverage was about 99.86%.

Modelling Robust Delivery Scenarios for a Fleet of Unmanned Aerial Vehicles in Disaster Relief Missions

Besides commercial and military applications, unmanned aerial vehicles (UAVs) are now used more commonly in disaster relief operations. This study proposes a novel model for proactive and reactive planning (different scenarios) that allow for a higher degree of realism, thus a higher likelihood for a mission of being executed according to the plan even when weather forecasts are changing. The novelty of this study results from the addition of a function of resistance of UAVs mission to changes in weather conditions. We link the influence of weather conditions on the UAV’s energy consumption. The goal is to ensure the completion of planned deliveries by a fleet of UAVs under changing weather conditions before their batteries discharge and to identify the emergency route for returned if the mission cannot be completed. An approach based on constraint programming is proposed, as it has proven to be effective in various contexts, especially related to the nonlinearity of the system’s characteristics. The proposed approach has been tested on several instances, which have allowed for analyzing how the plan of mission is robust to the changing weather conditions with different parameters, such as the fleet size, battery capacity, and distribution network layout.

An in Depth Analysis of Factors Contributing to Diagnostic Delay in Myeloma: A Retrospective UK Study of Patients Journey from Primary Care to Specialist Secondary Care

IntroductionPatients with Multiple Myeloma (MM) often have a significant delay between onset of symptoms and diagnosis of disease. As a result, a significant number of patients present via emergency routes with severe co-morbidities which affect survival rates. Timely diagnosis relies on the early recognition of symptoms and blood test results which may indicate disease.MethodsWe examined the medical records of 142 newly diagnosed MM patients (121 intact immunoglobulin and 21 light chains) across 2 UK Hospitals. Patients included had not previously been diagnosed with a plasma cell dyscrasia, including Monoclonal Gammopathy of Undetermined Significance (MGUS). Clinical symptoms and blood test results were examined from the time of initial presentation to the healthcare system with symptoms indicative of MM, to the point of diagnosis in order to highlight patterns of symptoms and blood tests results which may give an early indication of disease. Blood tests results recorded included globulin, calcium, creatinine, erythroid sedimentation rate and haemoglobin. Time to diagnosis from presentation with symptoms indicative of MM was also measured as well as the patient pathway from the point of presentation to the point of diagnosis.ResultsThe median time to diagnosis from initial presentation was 77 days (range 0 - 12,986). Initial presentation was most commonly via primary care (58.1%). Urgent secondary care presentation was documented in 28.5% which included acute medical unit (15.6%), the emergency department (7.1%), and other secondary care specialities (5.7%) respectively. Multiple GP visits were common prior to haematology referral with a median of 3 visits (range 1 - 40). Initial presenting symptoms varied, but of those with data recorded (n=107) back/bone pain was the most common (58.2%) followed by anaemia (18.7%), fracture (7.5%), recurrent infection (7.5%) and renal impairment (3.7%) respectively. Interestingly, analysis of evaluable blood test results revealed a raised globulin was most often evident prior to diagnosis with 58% of patients recording an abnormal globulin a median of 140 days (range 3 - 4297) prior to diagnosis of disease.ConclusionsMultiple GP visits prior to establishing a diagnosis of myeloma is very common. Inclusion of abnormal globulin to reflex electrophoresis request and serum free light chain assay may serve as a useful trigger for investigation when interpreted alongside presenting symptoms and other blood test results. Increased awareness of myeloma warning signs in primary care may reduce diagnostic delay and avoid presentation with severe co-morbidities in emergency settings. DisclosuresNo relevant conflicts of interest to declare.

Planning for relief distribution, victim evacuation, redistricting and service sharing under uncertainty

Prompt reactions to the vital emergency relief necessities right after sudden-onset disasters, which are included relief distribution and victim evacuation, are crucial to the mitigation of the disaster influences in the concerned regions. This paper renders a bi-objective optimization model to plan a humanitarian districted logistics network, in which a broad range of simultaneous decisions concerning emergency facility location-allocation, redistricting, service sharing, and routing of vehicles is considered. Two types of vehicle routing problems, namely closed and open, are worked out for land and air routing, respectively. Also, due to the uncertain nature of the disaster, ranging from demand and supply to varied costs, a hybrid robust optimization is proposed to overcome this challenge. Finally, the validity of the suggested model and solution approach on a real case study is investigated. The obtained results and rendered managerial insights reveal the proposed model and solution approach's applicability and effectiveness.

A GIS based flood vulnerability modelling of Anambra State using an integrated IVFRN-DEMATEL-ANP model

Flooding is a major environmental problem facing Anambra State of Nigeria, which also threatens food security in the state. To address this issue, continual flood vulnerability mapping exploring more efficient methods is needed to facilitate flood risk management in the state. The advantages of employing spatial information technologies such as Remote Sensing (RS) and Geographic Information System (GIS) in flood vulnerability mapping has been widely documented; the limitations of employing GIS alone in effective vulnerability analysis have also been documented by researchers. To overcome these limitations, this study adopted the use of GIS and the integration of Interval Value Fuzzy Rough Number (IVFRN), Decision Making Trial and Evaluation Laboratory (DEMATEL), and Analytical Network Process (ANP) method in vulnerability assessment of flood hazard. The result of the study shows that the state is very vulnerable to flood with 73% of the total area of the state lying between Very High and Medium vulnerable zones. The most vulnerable Local Government Area (LGA) in the State is Anambra West with 95% of the total area of the LGA lying between Very High and Medium vulnerable zones. Furthermore, the obtained values of R˜−D˜ show that Rainfall Intensity factor is the major cause of flood in the study area with the highest positive value of 1.55 and Soil factor is the major effect with the highest negative value of -0.93. The IVFRN-DEMATEL-ANP assessment model was validated using AUC-ROC method; an AUC value of 0.946 was obtained, this indicates that the model has excellent prediction accuracy. This study was able to establish the feasibility of integrating the IVFRN, DEMATEL and ANP methods in flood vulnerability assessment. It is recommended that the provision of adequate drainage systems should be prioritized to areas of high flood vulnerability index; to help mitigate flood hazards in the State. Also, strategic planning of infrastructures and emergency routes for moving people and key assets from vulnerable areas especially during the rainy season should be geospatial-based and systematic.

Insights into involuntary hospital admission procedures for psychiatric patients: A 3-year retrospective analysis of police records

The procedure of involuntary hospitalization has been an ongoing subject of study. Its implementation requires the systematic co-ordination between the Justice and Health Care systems around the globe. In the case of Greece, the procedure under discussion is regulated by Law 2071/1992, which designates the Police as the agent that links the aforementioned systems together. The present study aims to shed light upon the procedure of involuntary hospitalizations, regarding the preparatory stage and the Police involvement up to the individuals' admission to the on-call hospital for a mental health assessment (MHA). The entry data of two police stations in Athens was recorded by the respective Duty Officer responsible for each case. The police records were retrospectively inspected and information on socio-demographic, clinical and parametric characteristics was extracted. The data collection took place between March and July 2020 and included 324 cases, 80.3% of which referred to involuntary hospitalizations; 17.6% of sample cases did not meet the criteria of the procedure, as opposed to 1.9% of the cases in which the patients eventually ended up being voluntarily admitted and afterwards hospitalized for treatment. There was a statistically comparison of socio-demographic, clinical and parametric variables in relation to the status of hospitalization groups (involuntary, voluntary and no hospitalization). Additionally, statistical comparisons were made between parametric and clinical variables in relation to the type of prosecution order (written: standard route, oral: emergency route). Acute mental health deterioration accounted for around 45% of the total data and it has been identified as the main factor for informing the Hearings Prosecutor office mainly by the patient's family and subsequently proceeding to the issuance of an order (in either written or oral form) to the Police. This enables the Police to escort the individuals and lead them to a psychiatric unit for mental health assessment (MHA) and based on this, for involuntary hospitalization if deemed necessary. In 87.9% of the cases, the individual was transported by police vehicles over a time span ranging from the very same day to 22 days. In total, the written prosecution orders (63.6%) outnumbered the oral ones (36.7%). The findings of the present study demonstrate that the Prosecution order type varies significantly depending on the causes that instigated the involuntary hospitalization procedure. The psychiatric decision whether there should be hospitalization or outpatient therapy also significantly varies depending on the diagnosis. Lastly, the results point out that the need for improvement and further clarification of the aforementioned Greek Law is absolutely essential.

Investigating the inequalities in route to diagnosis amongst patients with diffuse large B-cell or follicular lymphoma in England

IntroductionDiagnostic delay is associated with lower chances of cancer survival. Underlying comorbidities are known to affect the timely diagnosis of cancer. Diffuse large B-cell (DLBCL) and follicular lymphomas (FL) are primarily diagnosed amongst older patients, who are more likely to have comorbidities. Characteristics of clinical commissioning groups (CCG) are also known to impact diagnostic delay. We assess the association between comorbidities and diagnostic delay amongst patients with DLBCL or FL in England during 2005–2013.MethodsMultivariable generalised linear mixed-effect models were used to assess the main association. Empirical Bayes estimates of the random effects were used to explore between-cluster variation. The latent normal joint modelling multiple imputation approach was used to account for partially observed variables.ResultsWe included 30,078 and 15,551 patients diagnosed with DLBCL or FL, respectively. Amongst patients from the same CCG, having multimorbidity was strongly associated with the emergency route to diagnosis (DLBCL: odds ratio 1.56, CI 1.40–1.73; FL: odds ratio 1.80, CI 1.45–2.23). Amongst DLBCL patients, the diagnostic delay was possibly correlated with CCGs that had higher population densities.ConclusionsUnderlying comorbidity is associated with diagnostic delay amongst patients with DLBCL or FL. Results suggest a possible correlation between CCGs with higher population densities and diagnostic delay of aggressive lymphomas.

Providing an acute oncology service during the COVID-19 pandemic

The COVID-19 pandemic has led to adaptations being made to all aspects of the NHS, including general practice, acute medical specialties and oncology. This has presented unique challenges to acute oncology services (AOSs) in how to provide continuity of care while maintaining the safety of patients and staff. We describe the experience of the AOS team at Barts Health NHS Trust, working across three acute hospitals in east London. Changes to the service due to COVID-19 included increased remote reviews and referrals to the specialist oncology cancer acute assessment unit. The patient population reviewed in April 2020 (at the initial peak of the pandemic in the UK) was markedly different to one reviewed in April 2019, with 55% more patients presenting with a new diagnosis of cancer via an emergency route. Finally, we suggest changes to AOSs for future waves of the pandemic.

The anatomical variations of the emergence routes of supraorbital nerve: A cadaveric study and systematic review

BackgroundKnowledge of the location of supraorbital nerve is essential to perform supraorbital endoscopic surgery, regional nerve block, and nerve decompression in the treatment of migraine. This study discusses the emergence routes of supraorbital nerve as well as a systematic literature review on previous anatomical studies. This comparative analysis will be beneficial for surgeons worldwide. MethodsThe study sample consisted of 19 cadavers with bilateral supraorbital nerve dissections. The emergence route of the nerve through either a notch or foramen was recorded. Additionally, the distance from midline, nerve branching patterns, and diameter of emergence routes were measured. ResultsOur findings showed an equal number of supraorbital emergence route between notch and foramen (42%) and demonstrated average distance from emergence route and facial midline 22.34 (3.05) mm in male and 23.58 ± 2.42 mm in female. Diameter of notch type is 3.97 (0.99) mm and 3.39 (1.09) mm in foramen type. Data from systematic review showed range of distance from emergence route to facial midline from 22.2 to 33.7 mm. East Asia population had significant shorter distance of supraorbital emergence route to facial midline than Middle Asia and Caucasian population. ConclusionThis study provides greater insight into the anatomic variations and supraorbital never course in an understudied minority population. Surgeons should be aware of this critical area and strive to minimize dissection to prevent iatrogenic nerve injury.