{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T20:48:20Z","timestamp":1740170900310,"version":"3.37.3"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1-2","license":[{"start":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:00:00Z","timestamp":1622419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Previous analyses of head, face, and neck (HFN) surgery in the deployed military setting have focused on the treatment of injuries using trauma databases. Little has been written on the burden of disease and the requirement for follow-up care. The aim of this analysis was to provide the most comprehensive overview of surgical workload in a contemporary role 3 MTF to facilitate future planning.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>The operating room database and specialty surgical logbooks from a U.S.-led role 3 MTF in Afghanistan were analyzed over a 5-year period (2016-2020). These were then matched to the deployed surgical TC2 database to identify reasons for treatment and a return to theatre rate. Operative records were finally matched to the deployed Armed Forces Health Longitudinal Technology Application-Theater outpatient database to determine follow up frequency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During this period, surgical treatment to the HFN represented 389\/1989 (19.6%) of all operations performed. Surgery to the HFN was most commonly performed for battle injury (299\/385, 77.6%) followed by disease (63\/385, 16%). The incidence of battle injury-related HFN cases varied markedly across each year, with 117\/299 (39.1%) being treated in the three summer months (June to August). The burden of disease, particularly to the facial region, remained constant throughout the period analyzed (mean of 1 case per month).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Medical planning of the surgical requirements to treat HFN pathology is primarily focused on battle injury of coalition service personnel. This analysis has demonstrated that the treatment of disease represented 16% of all HFN surgical activities. The presence of multiple HFN sub-specialty surgeons prevented the requirement for multiple aeromedical evacuations of coalition service personnel which may have affected mission effectiveness as well as incurring a large financial burden. The very low volume of surgical activity demonstrated during certain periods of this analysis may have implications for the maintenance of surgical competencies for subspecialty surgeons.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usab221","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T06:59:59Z","timestamp":1622444399000},"page":"93-98","source":"Crossref","is-referenced-by-count":0,"title":["Head Face and Neck Surgical Workload From a Contemporary Military Role 3 Medical Treatment Facility"],"prefix":"10.1093","volume":"187","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2352-1365","authenticated-orcid":false,"given":"John","family":"Breeze","sequence":"first","affiliation":[{"name":"Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6637-5572","authenticated-orcid":false,"given":"William","family":"Gensheimer","sequence":"additional","affiliation":[{"name":"Warfighter Eye Center, Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD 20762, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 88th SGC\/SGCO, Wright-Patterson Air Force Base, Dayton, OH 45433, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0536-8886","authenticated-orcid":false,"given":"Kathleen M","family":"Sarber","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, 96th Medical Group, Eglin AFB, FL 32542, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"issue":"2","key":"2022010618184527300_R1","first-page":"295","article-title":"Combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom","volume":"64","author":"Owens","year":"2008","journal-title":"J Trauma"},{"issue":"6 Suppl 5","key":"2022010618184527300_R2","doi-asserted-by":"crossref","first-page":"S431","DOI":"10.1097\/TA.0b013e3182755dcc","article-title":"Death on the battlefield (2001-2011): implications for the future of combat casualty care","volume":"73","author":"Eastridge","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"issue":"9\u201310","key":"2022010618184527300_R3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1093\/milmed\/usaa159","article-title":"Combat facial fractures sustained during Operation Resolute Support and Operation Freedom\u2019s Sentinel in Afghanistan","volume":"185","author":"Breeze","year":"2020","journal-title":"Mil Med"},{"key":"2022010618184527300_R4","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1093\/milmed\/usaa252","article-title":"Penetrating neck injuries treated at a U.S. Role 3 Medical Treatment Facility in Afghanistan during Operation Resolute Support","volume":"186","author":"Breeze","year":"2021","journal-title":"Mil Med"},{"issue":"3","key":"2022010618184527300_R5","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1177\/0194599812472874","article-title":"The joint facial and invasive neck trauma (J-FAINT) project, Iraq and Afghanistan 2003-2011","volume":"148","author":"Lanigan","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"5","key":"2022010618184527300_R6","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1097\/TA.0000000000002625","article-title":"Outcomes following penetrating neck injury during the Iraq and Afghanistan conflicts; 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