2024 CMF Resident Research Awards

Dr. Hari-Raj is currently a resident at Washington University School of Medicine in St. Louis, where she is conducting an important study titled “Local Anesthesia for Facial Fractures: A Randomized Controlled Trial,” also known as the LAFF RCT. When discussing the significance of her research, Dr. Hari-Raj explained, “This randomized, placebo-controlled, double-blinded trial investigates the impact of perioperative bupivacaine nerve blocks on pain, opioid consumption, and nausea following craniomaxillofacial (CMF) trauma surgery.” She emphasizes that this research presents a valuable opportunity to assess the effectiveness of a minimally invasive, low-cost intervention aimed at enhancing postoperative care for CMF trauma patients. Dr. Hari-Raj is motivated to pursue this line of research because uncontrolled pain and nausea can severely hinder patients' early mobility, oral intake, and ability to communicate after surgery. The shift towards multimodal pain management, which incorporates non-opioid adjuncts, aims to reduce opioid reliance in trauma surgery. While previous studies suggest that long-acting local anesthesia can significantly aid pain management in CMF trauma cases, there is still a lack of adequately powered and controlled research in this area. Looking ahead, Dr. Hari-Raj notes, “CMF trauma patients are often prescribed opioids, which carry a risk of dependence. Uncontrolled pain and nausea can lead to unexpected hospital admissions. By employing nerve blocks, we can mitigate the risks associated with opioid use—such as dependence, respiratory depression, and nausea—ultimately reducing morbidity and improving patient outcomes.” Dr. Hari-Raj is thrilled to have received the Resident Research Grant from AO CMF North America for this study. She appreciates the wealth of resources offered by the AO, particularly the AO Surgery Reference, which has been instrumental in her case preparations. She also plans to participate in AO courses during her residency. “I am honored that this project has the support of AO North America,” she stated.

Dr. Kyle Singerman is a resident at the University of Kansas Medical Center, where he is conducting research titled “Developing a Standardized Radiology Reporting Protocol for Maxillofacial Trauma CT Scans.” When asked about the significance of his work, Dr. Singerman emphasizes, “Computed tomography (CT) is crucial for diagnosing and managing maxillofacial trauma. However, the lack of standardization in radiologists’ terminology for specific fracture patterns can lead to confusion, misdiagnosis, and delayed or inadequate treatment.” He points out that prior research by Ludi et al. has identified a notable “language gap” between radiologists and surgeons, with a 40% discrepancy in the descriptors used in radiologic and operative reports. “This inconsistency can be attributed to the existence of multiple, often overlapping classification schemes. While facial trauma surgeons independently interpret maxillofacial CT images and recognize injury patterns, many rely on radiology reports to make initial decisions about patient referrals for further management.” Dr. Singerman is motivated by the increasing trend toward structured radiology reports, which have been shown to offer significantly greater clarity and content satisfaction, as well as higher overall preference among both surgeons and oncologists in other specialties. In contrast, the commonly used free text reporting for maxillofacial trauma scans can create ambiguity and confusion for both referring providers and surgeons.  Although some initial studies have begun to address the need for improved language in maxillofacial trauma reporting, none have yet made a formal effort to standardize this practice. The complexity of maxillofacial injuries—characterized by a diverse array of fracture patterns—makes such standardization all the more critical. Looking ahead, Dr. Singerman hopes to achieve multidisciplinary and multi-institutional consensus on a standardized reporting template for facial trauma CT scans through Delphi rounds. Broader adoption of these templates could facilitate research into provider satisfaction, enhance communication efficiency, and improve clinical outcomes. Additionally, a more standardized language could lead to better understanding among referring providers, paving the way for future educational initiatives aimed at emergency and primary care physicians—who are often the first point of contact for facial trauma patients before specialist referral. Dr. Singerman notes that AO CMF is the premier organization uniting clinicians from all subspecialties involved in treating craniomaxillofacial trauma. “Developing a shared terminology among these professionals would be significantly enhanced with AO support,” he states. The AO has already laid the groundwork for this initiative by establishing a comprehensive classification scheme for all maxillofacial fracture types. Dr. Singerman hopes that their efforts can further bridge the communication gap between surgeons, radiologists, and referring providers, ultimately improving care for the complex patient population that AO North America aims to serve.

Dr. Silverstein is currently a resident at Stanford University, where he is conducting research titled “Development of Chondrogenic Scaffolds for Temporomandibular Joint Cartilage Regeneration.” When asked about the importance of this research, Dr. Silverstein explained, “Like other joints in the human body, the temporomandibular joint (TMJ) is vulnerable to degenerative diseases such as osteoarthritis. The clinical manifestations of TMJ arthritis can be debilitating, contributing to a range of symptoms known as temporomandibular disorders (TMD), which affect 5% to 12% of adults and can result in severe jaw and facial pain, limited mouth opening, and psychological distress.” He is motivated to pursue this research because, “Despite its significant impact on quality of life, TMJ arthritis remains a condition with few effective treatment options. As a resident in Stanford's Plastic Surgery program, I have had the privilege of collaborating with a diverse group of surgeons and scientists committed to advancing TMD research. With such incredible support, I am excited to integrate our clinical expertise with basic science to develop innovative therapies for this complex issue.” Looking to the future, Dr. Silverstein notes that restoring healthy articular cartilage could dramatically improve the lives of millions suffering from osteoarthritis. “Our team believes that by gaining a deeper understanding of the cellular pathways that guide the differentiation of stem cells into bone and cartilage, we can promote endogenous repair of diseased joints, including the TMJ.” Dr. Silverstein also commended AO North America for its exceptional support of craniomaxillofacial research across various scales. “We are particularly grateful for their funding of resident-led projects, which helps cultivate the next generation of surgeon-scientists dedicated to addressing craniomaxillofacial pathology.”

Related pages