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IMJ Year End Finale: A Masterwork in Microsurgery

Tommy’s 3-5-7 Method: A Novel Surface-Landmark Technique for Minimally Invasive Identification of the Facial Nerve Buccal Branch

Yen-Ting Liu, MD; W.K. Fraser Hill, MD; Lisa Wen-Yu Chen, MD; Johnny Chuieng-Yi Lu, MD, MSCI; Jung-Ju Huang, MD, FACS; David Chwei-Chin Chuang, MD; Tommy Nai-Jen Chang, MD*

On this Christmas Eve, we feature the International Microsurgery Journal’s (IMJ) year end finale, a high caliber masterpiece by Editor-in-Chief Tommy Nai-Jen Chang and a prestigious cohort of heavyweight authors. Tommy’s 3-5-7 method offers a transformative advancement in facial nerve surgery, resolving the long standing compromise between surgical exposure and aesthetic integrity. By utilizing a precise coordinate system of 3.5 cm anterior and 0.7 cm caudal to the tragus, surgeons can rapidly identify the buccal branch through a minimal 5 cm preauricular incision. This protocol bypasses the morbidity of deep proximal dissection and avoids visible scarring, providing a reproducible solution that prioritizes both functional preservation and cosmetic outcomes.

Article: https://scitemed.com/article/5439/scitemed-imj-2025-00203

PDF: https://scitemed.com/upload/5843/5439/scitemed.imj.2025.00203.pdf?t=2148

Evidence Infrastructure: Redefining the Role of Reviews in Clinical Decision-Making

Chin-Lung Kuo, MD, PhD*

The author reframes review articles as evidence infrastructure that updates clinical consensus and identifies research gaps. The author argues that narrative reviews integrate findings across biological scales and translate molecular data into clinically meaningful explanations of disease behavior. Using cholesteatoma, the author illustrates how molecular evidence can recast invasiveness and recurrence into a mechanistic model that also motivates the pursuit of nonsurgical therapies. The author contrasts this interpretive role with systematic reviews, which function as reproducible decision chains grounded in transparent, verifiable methodology. Finally, the author cautions that AI assisted automation can propagate error unless it is governed by expert oversight within a human in the loop model that preserves auditable decision chains.

Article: https://scitemed.com/article/5443/scitemed-aohns-2025-00202

PDF: https://scitemed.com/upload/3714/5443/scitemed.aohns.2025.00202.pdf?t=0116

Assessment of Nurses’ Self-Perceived Competence and Confidence in Providing Diabetes Education: A Quality Improvement Initiative

Clare Koning, PhD*; Adinet Lock, PhD; Breanne Kelly, MN; Sheila Finamore, MSN; Laurie Rosenzweig, MSN; Kashmiro Kainth, MHS

This quality improvement project highlights a critical shift in diabetes care. Acute care nurses report moderate competence, yet significant confidence gaps remain, particularly in insulin management and the use of new technologies under constant time pressure. These findings challenge the reliance on informal, nurse-led education and call for structured, multidisciplinary models with dedicated diabetes educators and digital tools designed for high-acuity settings. The study underscores the urgent need for targeted training to close these gaps, improve patient safety, and strengthen nurses’ roles as key protectors in chronic disease management.

Article: https://scitemed.com/article/5375/scitemed-de-2025-00199

PDF: https://scitemed.com/upload/5794/5375/scitemed.de.2025.00199.pdf?t=2131

Microsurgical Lymphatic Reconstruction for Refractory Chylous Ascites in Systemic Lupus Erythematosus: Case Report and Literature Review

Ravikiran Naalla, MCh*; Srikant Aruna Samantaray, MCh; Sanjeev Patil, MS, DNB; Guduru Venkat Rao, MS, M**S, FRCS; Duvvur Nageshwar Reddy, MD, DM, DSc, FRCP

This article presents the first comprehensive review of refractory chylous ascites associated with systemic lupus erythematosus, analyzing 19 cases to propose an evidence-based therapeutic framework. It introduces lymphatic bypass surgery as an effective option for this rare complication, overcoming the limitations of conventional treatment. By integrating mechanical drainage, immunomodulation, and lymphangiogenesis, this approach achieves rapid and sustained resolution of ascites. The findings offer a novel surgical strategy for autoimmune lymphatic disorders and prompt a re-evaluation of their complex pathophysiology. This study demonstrates how surgical innovation can succeed where traditional therapies fail, offering new hope in managing refractory autoimmune disease.

Article: https://scitemed.com/article/4364/scitemed-imj-2025-00197

PDF: https://scitemed.com/upload/171/4364/scitemed.imj.2025.00197.pdf?t=0631

Optimizing Dysphagia Management in Head and Neck Cancer Radiotherapy: Advanced Imaging, Precision Dosimetry, and Rehabilitation

Sayan Kundu*; Bitan Pramanik; Chandrani Mallik; Koustav Majumder; Amitabh Ray

This narrative review advances the management of radiation-induced dysphagia in head and neck cancer treatment by integrating advanced imaging, precision dosimetry, and structured rehabilitation. Beyond focusing solely on dysphagia-optimized intensity-modulated radiotherapy, it explores a variety of approaches: MRI and CT provide detailed anatomical insights, while proton therapy offers a less toxic alternative, and early rehabilitation preserves swallowing function. This holistic model prioritizes patient quality of life, detailing how techniques like Do-IMRT reduce radiation to critical structures like the pharyngeal constrictors and larynx, maintaining effectiveness. The review advocates a multidisciplinary approach, encouraging collaboration among oncologists, radiologists, and therapists to enhance long-term patient well-being and promoting further research to elevate care standards.

Article Access:
Article Link: https://doi.org/10.24983/scitemed.aohns.2025.00194
PDF Download: https://scitemed.com/upload/5770/4344/scitemed.aohns.2025.00194.pdf?t=0513