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Raffaele Rauso,1 Giovanni Francesco Nicoletti,2 Nicola Zerbinati,3 Giorgio Lo Giudice,4 Romolo Fragola,1 Gianpaolo Tartaro5 1Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialists, University of Campania “Luigi Vanvitelli”, Naples, 80138, Italy; 2Plastic Surgery Unit, Multidisciplinary Department of Medicine, Surgery and Odontological Sciences, “Luigi Vanvitelli” University Hospital, Naples, Italy; 3Dermatology, Department of Medicine and Surgery, “Insubria” University Hospital, Varese, Italy; 4Maxillo-Facial Surgery, Department of Neurosciences, Reproductive and Odontological Sciences, “Federico II” University Hospital, Naples, Italy; 5Maxillo-Facial Surgery Unit, Multidisciplinary Department of Medicine, Surgery and Odontological Sciences, “Luigi Vanvitelli” University Hospital, Naples, ItalyCorrespondence: Raffaele RausoOral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania “Luigi Vanvitelli”, Naples 80138, ItalyEmail raffaele.rauso@unicampania.itAbstract: The purpose of the present study is to review published literature regarding complications following self-administration of hyaluronic acid (HA) filler. The following keywords were searched in Pubmed and Cochrane database: filler AND self injection, hyaluronic acid AND self injection; filler AND self administration; hyaluronic acid AND self administration. Two authors performed title and abstract eligibility assessment independently. Gray literature and all articles cited in the included papers were also screened and their reference lists were examined to identify other potentially pertinent studies. Non-English papers were excluded. A total of 4 complications following self injection of HA were identified. Conversely, after performing a general search through the Google Internet search engine, with the item “self-injection of hyaluronic acid filler”, there were 604,000 hits. The number of articles reporting complications after the self administration of HA is few. Despite that internet searches on the same topic shows that self-administration of HA fillers is a widely discussed phenomenon in several on-line forums. The present review suggests that complications after self-injection of HA are an under-reported phenomenon.Keywords: self-administration, DIY, self-injection, complication

Descending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature. Surgical and therapeutic management has been discussed for long time especially in an elderly patient population. The literature has been reviewed in order to evaluate different pathogenesis and evolution and to recognise a correct therapeutic management.