Background: Head and neck infections are commonly caused by affections with an odontogenic origin. Untreated or non-responsive to treatment odontogenic infections can cause severe consequences such as localized abscesses, deep neck infections (DNI), and mediastinitis, conditions where emergency procedures such as tracheostomy or cervicotomy could be needed. Methods: An epidemiological retrospective observational study was performed, and the objective of the investigation was to present a single-center 5-years retrospective analysis of all patients admitted to the emergency department of the hospital Policlinico Umberto I “Sapienza” with a diagnosis of odontogenic related head and neck infection, observing the epidemiological patterns, the management and the type of surgical procedure adopted to treat the affections. Results: Over a 5-year period, 376,940 patients entered the emergency room of Policlinico Umberto I, “Sapienza” University of Rome, for a total of 63,632 hospitalizations. A total of 6607 patients were registered with a diagnosis of odontogenic abscess (10.38%), 151 of the patients were hospitalized, 116 of them were surgically treated (76.8%), and 6 of them (3.9%) manifested critical conditions such as sepsis and mediastinitis. Conclusions: Even today, despite the improvement of dental health education, dental affections can certainly lead to acute conditions, necessitating immediate surgical intervention.

Objective: Fascia lata (FL) is a worldwide adopted source of autologous grafts. In our Department, the endoscopic endonasal transphenoidal surgery (EETS) has been performed regularly for anterior and middle cranial fossa lesions, and FL graft has commonly been a practical resource in repairing tissue defects after EETS. Enough, we used routinely harvesting FL to restore symmetry in facial palsy. To our known, this is the biggest case series about FL harvesting to repare tissue defects after EET. The purpose of our study was to evaluate our experience with the harvesting of FL, in particularly the donor site morbidity. Study design: This is a prospective study case series, which evaluated by questionnaire the morbidity of FL donr site. Methods: The details of 44 patients were analyzed from 2011 to 2016. Thirty-eight patients needed cranial base reconstruction and 6 patients needed facial reanimation. Results: Adequate length of FL was harvested in all our patients. There were no intraoperative complications. We did not use drain in any case. We analyzed 18 women (40%) and 26 men (59.9%). The estimated median age at presentation was 51.53. Conclusion: For little FL's gap, diameter until 3 × 6 cm, it's possible to suture FL's margin with Nylon, but for bigger gap it's necessary to reconstruct with allograft to avoid muscle bulge or compartmental syndrome.

Objectives: The purpose of this article is to evaluate endoscopic-assisted technique by lateral approach for sinus floor augmentation, to reduce the incidence of Schneiderian membrane perforation, and to guarantee a sufficient apposition of new bone even in the posterior maxillary sinus. Methods: From January 2017 to December 2017, 10 patients affected by severe maxillary atrophy underwent endoscopic-assisted sinus augmentation using a lateral approach. Results: In only 1 patient, a little perforation of sinus membrane was observed intraoperatively and it was repaired. No abnormal postoperative bleeding was observed. None of the patients experienced oro-antral fistula, infection, or V2 dysesthesia. The authors did not find radiologic evidences of biomaterial displaced on the maxillary sinus or postoperative sinusitis. Conclusions: The authors evaluated endoscopic-assisted maxillary sinus augmentation technique using a lateral approach that allows a direct and clear view of the surgical field. This technique, as the preliminary results demonstrate, is safe and helpful, especially in avoiding membrane perforation and in xenograft optimal distribution. It could be very useful in retreatment patients.

Background: Polyetheretherketone (PEEK) is a synthetic material with many favorable characteristics; PEEK implants are increasingly used for a variety of applications ranging from cranioplasty to orthopedic surgery and facial implants. Methods: This study is a retrospective review of patients who underwent PEEK implant placement in our department over the last 5 years. Polyetheretherketone computer-aided design and manufacture facial implants were designed from high-resolution computed tomography (CT) scans of each patient. The implants placed were onlay implants used for facial rehabilitation purposes to correct malformative and posttraumatic malformations. Results: Twenty-eight consecutive patients (11 males and 17 females) underwent PEEK implant positioning between January 2015 and December 2020. Common indications were anterior plagiocephaly, hemifacial microsomia, and residual facial imbalance after orthognathic surgery. No complications of implant breakdown, exposure, infection, or displacement were noticed during the follow-up period. During routine controls on 3 patients, we requested a craniomaxillofacial CT scan for reasons unrelated to the implanted prostheses. The CT scans were all high resolution (<1-mm slices). The CT images indicated that bone was starting to form around the implant in all 3 patients as well as in the penetrating holes that were planned in the implants. Conclusions: In our experience, computer-designed, patient-specific PEEK onlay implants are a valid option for the treatment of malformative and posttraumatic malformations. This is, to the best of our knowledge, the first clinical report on bone reaction to PEEK implantation in the maxillofacial field. Moreover, based on the signs of bone regrowth that we observed in CT controls we can presume that the design of this type of prosthesis can probably take advantage of some technical stratagems not yet codified and fully exploited. Despite our preliminary favorable results, further multicentric and comparative studies are necessary to evaluate outcomes and better understand the behavior of this promising material and thus optimize its use in craniomaxillofacial surgery.

The complexity of multimodal approaches in cancer management has lately led to the establishment of multidisciplinary tumor boards (MDTBs) to define targeted, patient-centered treatment strategies. However, few data are available regarding the application of this approach in Ocular Oncology. Hereby, the Authors analyze the implementation and outcomes of a trained MDTB in a tertiary ocular oncology referral center. A retrospective descriptive analysis of MDTB meetings discussing patients with ocular and periocular cancers, over a 12-months period, was carried out. Data were grouped by main site involved, topics discussed and final clinical decisions therefore taken. Meetings were held by a constant ‘Core team’ or – when required – by a broader ‘Extended team’. During the observational period 86 cases were discussed. In 27 patients ocular surface tissues were involved (31%), in 25 patients orbital tissues (29%), in 22 patients eyelids (26%), and in 12 patients intraocular tissues (14%). In 13 cases (15%) naïve or referred new patients, in 34 cases (40%) imaging or histopathologic reports and in 39 cases (45%) treatment plans were discussed. Regarding final decisions, a treatment plan was scheduled in 47 cases (55%) and a diagnostic ascertainment was required in 27 patients (31%); locally advanced and/or systemic diseases were referred or teamed up with other specialists in 12 cases (14%). Ocular Oncology multidisciplinary team, by sharing expertise of different specialists, ensures a comprehensive evaluation of patients improving the accuracy of diagnosis and staging upon which planning a proper treatment. Further studies are needed to assess if this approach may also improve the outcomes and prognosis of patients.

Purpose: This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, which matches a pair of 2D or 3D point clouds with unknown dependencies of the transition from scan s_(k) to scan s_(k+1). Methods: The study population was composed of ten patients who presented to the Maxillofacial Surgery Department of the University “Sapienza” of Rome for the evaluation and management of skeletal malocclusions. The patients were divided into two groups, depending on the technique used: group 1: splintless group (custom-made cutting guide and plates); group 2: splint group (using a 3D-printed splint). STL files were imported into Geomagic^® Control X™ software, which allows for comparison and analysis using an ICP algorithm. The RMSE parameter (3D error) was used to calculate the accuracy. In addition, data were compared in two different patient subgroups. The first subgroup only underwent a monobloc Le Fort I osteotomy (p-value = 0.02), and the second subgroup underwent a Le Fort I osteotomy associated with a segmental osteotomy of the maxilla (p-value = 0.23). Results: Group 1 showed a 3D error of 1.22 mm ± SD 0.456, while group 2 showed a 3D error of 1.63 mm ± SD 0.303. These results have allowed us to compare the accuracy of the two CAD/CAM systems (p-value = 0.09). Conclusions: The ICP algorithm provided a reproducible method of comparison. The splintless method would seem more accurate (p-value = 0.02) in transferring the surgical programming into the operating room when only a Le Fort I osteotomy is to be performed.