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A young girl was referred to our Institution for the appearance of a painless soft swelling in the right parietal region of the scalp. In the same site, the patient had a parietal bone fracture 1 year ago. In the suspicion of a growing skull fracture, the patient underwent radiological investigations. Ultrasound showed a soft, poorly vascularised swelling with parenchymatous content. The skull X-ray showed an apparent healing of the previous fracture. CT scan and MRI confirmed the correct healing of the fracture and described the presence of a lipomatous mass. The mass was surgically removed and histology confirmed the diagnosis of encapsulated lipoma. The postoperative period was uneventful, with no evidence of infections or recurrence in the 6-month follow-up.

Purpose: the purpose of this study was to retrospectively analyze the clinical records of patients admitted for maxillo-facial fracture to 18 Italian center, evaluating the epidemiological differences between the different phases of the SARS-CoV-2 pandemic. Methods: This is a retrospective study on patients who underwent surgery for facial bone fractures in 18 maxillo-facial surgery deparments in Italy, from February 23, 2020 to February 23, 2022. According to the date of admission, all the data were stratified in four chronological periods encompassing the four different moments in terms of restriction in Italy: pre-pandemic, first wave, partial restrictions and post-pandemic groups. Differences in epidemiological data between the groups were analysed. Results: 2,938 patients were included. There was a statistically significant difference in the cause of hospitalization between pre-pandemic and first wave groups (p=0.005) and between pre-pandemic and partial restriction groups (p=0.002). The differences between the pre- and post-pandemic groups where instead not significant (p=0.106). Compared to the pre-pandemic period, the number of Black patients was significantly higher during the first wave and the post-pandemic period. Differences between the periods in terms of gender, age, type of fracture, treatment modality, and length of hospital stay were not found to be statistically significant. Conclusions: during the COVID-19 pandemic there have been profound changes in the epidemiology of fractures influenced by the restrictive measures implemented by the government. At the end of the pandemic, the epidemiology of fractures returned to being the same as in the pre-pandemic period.Purpose: the purpose of this study was to retrospectively analyze the clinical records of patients admitted for maxillo-facial fracture to 18 Italian center, evaluating the epidemiological differences between the different phases of the SARS-CoV-2 pandemic. Methods: This is a retrospective study on patients who underwent surgery for facial bone fractures in 18 maxillo-facial surgery deparments in Italy, from February 23, 2020 to February 23, 2022. According to the date of admission, all the data were stratified in four chronological periods encompassing the four different moments in terms of restriction in Italy: pre-pandemic, first wave, partial restrictions and post-pandemic groups. Differences in epidemiological data between the groups were analysed. Results: 2,938 patients were included. There was a statistically significant difference in the cause of hospitalization between pre-pandemic and first wave groups (p=0.005) and between pre-pandemic and partial restriction groups (p=0.002). The differences between the pre- and post-pandemic groups where instead not significant (p=0.106). Compared to the pre-pandemic period, the number of Black patients was significantly higher during the first wave and the post-pandemic period. Differences between the periods in terms of gender, age, type of fracture, treatment modality, and length of hospital stay were not found to be statistically significant. Conclusions: during the COVID-19 pandemic there have been profound changes in the epidemiology of fractures influenced by the restrictive measures implemented by the government. At the end of the pandemic, the epidemiology of fractures returned to being the same as in the pre-pandemic period.

Using both endoscope and exoscope in cleft soft palate surgery is not widespread, despite the potential advantages related to view magnification, ergonomic posture of the surgeon, and involvement of the surgical team. The aim of the current study is to compare endoscopic (Olympus Visera©) and exoscopic (Karl-Storz Vitom©) assistance in cleft soft palate surgery in a preclinical cadaver setting. A formalin fixed specimen was dissected to mimic the anatomical conditions of a cleft soft palate. Ten young surgeons with limited experience in transoral surgery were involved in the exercitation on the specimen. The exercitation consisted of 4 tasks: (1) device setting; (2) identification of muscle plane; (3) muscle suturing; (4) oral mucosa suturing. Participants were timed while performing each task both with exoscope and endoscope and asked to fill in 2 questionnaires related to the visual systems used (NASA Task Load System TLS and VAS 1-10). All surgeons completed the 4 tasks with both the endoscope and exoscope. The execution times were similar except for faster setting of the exoscope. Participants felt that completing surgical exercises using the exoscope required less physical, intellectual, and temporal efforts compared to the endoscope. The exoscope was also more appreciated for its handling, 3D visualization, and limited encumbrance. Exoscope scored better both at NASA TLS and VAS 1-10 and required a faster setting than endoscope. Further clinical in-vivo studies are required to explore the advantages of these devices in cleft palate repair.

Reconstruction of full-thickness total or subtotal lower lip defects represents a challenge for the reconstructive surgeon because of the difficulty to create a functional and aesthetically good lip. Many surgical techniques, going from local to free flaps, have been reported, each of them having its own advantages and disadvantages. In particular, the free fascio-cutaneous flaps in most cases are the first reconstructive option, even though several disadvantages such as the complexity of the procedure, longer operative times, morbidity, longer hospitalization, and conspicuous donor-site scar. To avoid these problems, especially in aged patients and in presence of low compliance and/or comorbidities, the Authors propose a single stage reconstruction with a double overlying cervical flap.