Vincent B. Ziccardi1, Jin Ye Yeo2
1Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, NJ, USA; 2FOMM Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. FOMM Editorial Office, AME Publishing Company. Email: fomm@amegroups.com
This interview can be cited as: Ziccardi VB, Yeo JY. Readers’ Choice: Author Interview with Dr. Vincent B. Ziccardi. Front Oral Maxillofac Med. 2024. Available from: https://fomm.amegroups.org/post/view/readers-rsquo-choice-author-interview-with-dr-vincent-b-ziccardi.
Expert introduction
Dr. Ziccardi attended college at New York University, where he received a Bachelor’s degree in Chemistry. From there, he attended Columbia University and earned his dental degree. Upon graduation from Columbia, he was accepted into the integrated MD/Oral and Maxillofacial Surgery residency training program at the University of Pittsburgh, where he earned his MD degree and certificate in oral and maxillofacial surgery. It was during this time working with the faculty in both the oral and maxillofacial surgery and neurosurgery departments that he gained interest and experience in the management of trigeminal nerve injuries.
Upon completion of training, Dr. Ziccardi took a position as Assistant Professor at Mount Sinai Medical Center in New York City. He worked at this institution until taking a position at his current home at Rutgers School of Dental Medicine in 1997. While working in New Jersey, he was initially made residency program director in 1998 and ultimately Chair of the Department and Chief of Dental Medicine at University Hospital in 2001. He is presently a tenured Professor at the University and holds a co-terminus position in the Division of Plastic Surgery.
During his career, areas of clinical interest and research have included trigeminal nerve microsurgery, cleft lip and palate reconstruction, and complex reconstructive surgery. Dr. Ziccardi is an extensively published and nationally recognized expert in trigeminal nerve microsurgery and a speaker on this subject matter. He continues to serve as Chair and Chief of Service within the University Hospital and Associate Dean of Hospital Affairs as well as the Director of the Craniofacial Center at University Hospital.
Dr. Ziccardi's article, “Trigeminal nerve injuries in oral and maxillofacial surgery: a literature review”, published in our journal, has received an outstanding readership and entered the journal’s Most Read Article List.
Figure 1 Dr. Vincent B. Ziccardi
Interview
FOMM: What inspired you to pursue a career in oral and maxillofacial surgery (OMFS)?
Dr. Ziccardi: As a child, my mother worked as an office manager for a dental office and I became friendly with her dentist and became interested in the profession of dentistry from his guidance. Once in dental school at Columbia University, I was enrolled in the medical school curriculum for the first two years of training and found that oral and maxillofacial surgery would enable the combination of both dental and medical training. I completed some externships as a student and “hung out” with the OMFS residents, and time allowed me to solidify my decision to pursue OMFS training.
FOMM: Your article on trigeminal nerve injuries garnered significant attention. What motivated you to write about this topic, and why do you think it resonates with both practitioners and patients?
Dr. Ziccardi: Trigeminal nerve microsurgery is a major focus of my practice. There are very few specialists involved in the regular management of patients with trigeminal nerve injuries and the article was written to provide guidance as to some standards for evaluation and referral to specialists of patients with these injuries. FOMM provides a nice platform for the dissemination of this information as an open-access journal to disseminate this information.
FOMM: In your article, you discuss the role of trigeminal nerve microsurgery for persistent cases. Can you walk us through what this procedure entails and the key challenges associated with it?
Dr. Ziccardi: Trigeminal nerve microsurgery is an outpatient procedure performed under general anesthesia. The surgery is completed using some magnification such as surgical loupes or operating microscope with multiple heads which is our preference for teaching. Based on the intraoperative findings, different procedures may be performed ranging from external decompression to indirect neurorrhaphy with nerve grafts. All the nerves are entubulated with biological conduit to guide regeneration and prevent local scarring.
FOMM: For surgeons who are less familiar with trigeminal nerve microsurgery, what do you think is the most important aspect for them to understand, both in terms of surgical technique and post-operative care?
Dr. Ziccardi: The most important aspect of managing trigeminal nerve injuries is recognition, documentation with neurosensory testing, and timely referral to microsurgical specialists for those patients not demonstrating any neurosensory improvement. Certain types of injuries such as open or witnessed nerve transections and foreign material within the nerve canal from endodontic procedures warrant immediate referral for surgical management.
FOMM: As an expert in this field, what gaps or areas of improvement do you see in the treatment of trigeminal nerve injuries? How do you think the broader oral surgery community can address these challenges?
Dr. Ziccardi: The one area of improvement can be the timing of referral to skilled microsurgeons. All too often, patients report they are told to wait for spontaneous regeneration, and by the time they are evaluated, there is already a decrease in their prognosis for sensory improvement. If patients are not making any significant improvement, it is ideal for them to have a referral by 2-3 months post-injury. In cases of observed injury or the presence of foreign bodies, referral should be immediate to prevent the development of neuropathic pain.
FOMM: What advice do you have for oral and maxillofacial surgeons who are early in their careers?
Dr. Ziccardi: OMFS is a wonderful specialty bridging the fields of medicine and dentistry. You have training in the full scope of our specialty as a resident and my hope is that many of our young graduates will continue to practice the full specialty and consider academic career opportunities. We are always in need of more academic surgeons and researchers to train our future surgeons.
FOMM: Looking ahead, what do you see as the biggest opportunities in the field of oral and maxillofacial surgery in the coming years?
Dr. Ziccardi: Within the area of trigeminal nerve microsurgery, I see the use of adjuncts such as conduits, growth factors, and stem cells as the areas of opportunities to optimize our patients’ outcomes. Other areas of potential opportunities in OMFS include minimally invasive procedures, computerized surgical planning, and robotic-assisted surgery.