Background: The scalp region represent a common area affected by benignant and malignant skin tumor, and it represents a surgical challenge when it is needed to be reconstructed. The aim of this study is to present our experience with full-thickness scalp skin defects, reconstructed using Matriderm^® dermal substitute and split-thickness skin graft (STSG). Methods: A retrospective analysis of patients treated for scalp region reconstruction was conducted with 16 patients. All patients underwent the same procedure: scalp full-thickness tumor excision with simultaneous reconstruction with Matriderm^® and the application of a split-thickness skin graft in the same surgical time. During follow-ups, the surgical outcome was evaluated by accurate clinical examination of the wound, adopting the Vancouver Scar Scale (VSS). Results: The outcomes obtained were satisfying: wound healing at the end of the procedures was optimal, grafted skin resulted similar to surrounding tissue, and pigmentation and vascularity showed a decrease in the period between 6 months and 1 follow-up. Conclusions: The use of Matriderm^® and split-thickness skin grafting for scalp full-thickness defects reconstruction resulted in an optimal, stable, and safe procedure, suitable for elderly patients.

Zygomaticomaxillary complex and isolated orbital walls fractures are one of the most common fractures of the midface, often presenting orbital symptoms and complications. Our study was born with the aim of understanding the trend in the incidence of orbital presurgical symptoms, specifically diplopia, enophthalmos and exophthalmos, in the Campania Region in southern Italy. We conducted a retrospective, monocentric observational study at the Maxillofacial Surgery Unit of the Federico II University Hospital of Naples, enrolling 402 patients who reported a fracture of the zygomaticomaxillary complex and orbital floor region from 1 January 2012 to 1 January 2022. Patients were evaluated by age, gender, etiology, type of fracture, preoperative orbital side effects and symptoms. Pre-surgical side effects were studied, and 16% of patients (n = 66) developed diplopia. Diplopia was most common in patients previously operated on for orbital wall fractures (100%), and least common in patients who reported trauma after interpersonal violence (15%) and road traffic accidents (11%). Exophthalmos appeared only in 1% (six cases); whereas it did not appear in 99% (396 cases). Enophthalmos was present in 4% (sixteen cases), most commonly in interpersonal violence cases (two cases). The frequency of orbital complications in patients with zygomaticomaxillary complex and isolated orbital walls fractures suggests how diplopia remains the most common pre-surgical orbital side effect.

Ocular trauma remains a significant cause of vision loss, often resulting from penetrating injuries caused by foreign bodies such as glass, metal, wood, and other materials. Despite advancements in ocular surgery, retained intraorbital foreign bodies may lead to delayed complications if not promptly identified and managed. We present the case of a 59-year-old male who reported severe right eye pain and diplopia seven years following a work-related facial injury. Initially asymptomatic, a computed tomography (CT) scan later identified a 30-mm metallic foreign body lodged in the medial orbit. Surgical removal via anterior orbitotomy successfully alleviated symptoms, leading to the restoration of normal visual function and improvement of the patient's visual acuity to 10/10. This case highlights the importance of comprehensive evaluation in patients with a history of ocular trauma, even in the absence of immediate symptoms. While retained intraorbital foreign bodies may remain inert for extended periods, they can eventually cause chronic inflammation, pain, and other complications. CT imaging remains crucial for detecting metallic foreign bodies, and timely surgical intervention is essential to prevent further complications and preserve vision. Additionally, the case underscores the importance of preventive safety measures in the workplace to reduce the risk of such injuries.

Focal suppurative bacterial infections of the central nervous system (CNS), such as subdural empyemas and brain abscesses, can occur when bacteria enter the CNS through sinus fractures, head injuries, surgical treatment, or hematogenous spreading.