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Background: COVID-19 is a global pandemic. The virus spreads through respiratory droplets and close contact. Therefore, the availability of personal protective equipment (PPE) for healthcare professionals is essential. 3D printing technology could represent a valid option to ameliorate PPE shortages. Methodology: Custom-made face mask were designed on the basis of facial scan and then 3D-printed. The whole protocol is executed with freeware software and only required a 3D printer. Six healthcare workers wore the device weekly thus expressing a judgment regarding quality of work, respiratory and skin comfort. Results: The estimated total cost of a single mask is approximately 5 USD. The virtual design of a complete mask lasted 68 minutes on average. Most healthcare workers rated comfort as very good. Conclusions: Based on the encouraging results obtained, we can confidently confirm that custom-made masks are novel and useful devices that may be used in the fight against COVID-19.

Lower eyelid reconstruction for defects greater than 50% is a much discussed topic in literature. The aim of this paper is to present an “all-in-one” surgical technique based on the combination of modified Tenzel flap and palatal mucosal graft to restore the anatomical integrity. In our paper we present a case report of 64 years old patient admitted in Maxillo-Facial Surgery Unit of Polyclinic Federico II of Naples in January 2020. He was affected by lower eyelid basal cell carcinoma, measuring 1.5 cm in diameter. He was treated removing full-thickness neoplasia, leaving a surgical gap of 2 cm. Reconstruction was performed using modified Tenzel flap to cover the skin gap and a palatal graft for the reconstruction of the tarsal region structural integrity. This "all-in-one" technique can handle full thickness eyelid defects with the advantage of respecting the dual layer eyelid structure without the need of a secondary surgical step. Moreover, has shown excellent results for both the preservation of eyelid competency and the low complications rate like ectropion and lagophthalmos.

Purpose Over 70% of patients suffering from dentofacial deformity mention esthetics as the biggest issue pushing them to look for orthodontic and orthognathic treatment. At present, several software for computer-aided surgery have been released on the market, this surgical planning software allow surgeons to manipulate digital representations of hard and soft tissue profile tracings and subsequently morph the pretreatment image to produce a treatment simulation. The aims of this study was to investigate and find the difference between 2 of the most used digital software in the pre-surgical planning for patients affected by dentofacial deformities. Methods That was granted by using the following parameters: usability, validity, timing, accessibility, efficacy and predictability of the pre-surgical planning and the software costs. Ethical approval, to access and use the data, was obtained from the Federico II Research Ethic Committee (371/2019, approved in 21/02/2020). Results Analyzing the results obtained from our study, it is correct to define both software tools useful and valid in the digital surgical planning for treatment of patients with dentofacial deformities. Each software has negligible differences in performance that do not in any way affect the success of the surgical planning. Conclusion Despite a slight difference regarding the costs for the purchase of the license, which see the IPS software slightly more expensive than the Dolphin software, the IPS software represents not only a valid alternative to the most popular and tested Dolphin Imaging software, but it is even inclined to evaluate it better in terms of accuracy, effectiveness, and reliability.

Orbital floor Fractures are the most common fractures involving the facial skeleton and usually occurs after traumatic events. The reconstruction of the orbital floor can be performed with different biocompatible materials. The aim of our retrospective study is to analyze the short- and long-term outcomes of surgically treated patients based on the material used to repair the orbital floor.We enrolled 146 patients hospitalized for orbital floor fractures in the Maxillofacial Surgery Unit of the Federico II University of Naples from 1 to 2010 to July 2020. All the fractured orbital floors were reconstructed with non-resorbable (Titanium Mesh, SynPor, SuPor and MedPor implants) or resorbable (collagen membrane, bovinum pericardium membrane, autologous bone graft) materials.We utilized non-resorbable materials in 56% (82 cases) and resorbable implants in 44% (64 cases). An improvement of the preoperative symptomatology and an aesthetical good outcome was achieved in most cases.Data obtained supports that both resorbable and non-resorbable materials for orbital floor reconstruction are a safe and effective alternatives and offer satisfactory results in functional and aesthetic evaluations.

Background: The aim of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, are associated with overall survival (OS) in patients surgically treated for malignant salivary gland tumors (MSGTs). Methods: A retrospective analysis of 74 cases following surgery at our department between January 2011 and June 2018 was performed. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Survival curves of different groups at 1–3–5 years were estimated using the Kaplan–Meier method. Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The ROC curves revealed that the best combination with AUC = 0.884 was SII + SIRI. The estimated 5-year OS probability in patients with SII+ SIRI scores of 0, 1, and 2 was 96%, 87.5% and 12.5%, respectively (p < 0.001). Conclusion: SII+ SIRI can independently predict the OS of patients after MSGT surgery. The prognostic score system based on SII+ SIRI may be good clinical practice as a reference for clinical decision-making.

Cryotherapy after orthognathic surgery is essential for the control of facial edema. The aim of our study is to evaluate the efficacy of Hilotherapy face mask in reducing facial edema after orthognathic surgery, studying facial surfaces with an innovative, fast, economical 3D facial scan system based on an iPhone app. Eighty-four patients with Class III were included: 35 patients treated with Hilotherm after orthognathic surgery (Group 1), 32 patients with ice packs (Group 2), 7 patients who refused cryotherapy (not 1 - not Group 2). Their facial scans performed immediately after surgery (T0), at 24 (T1), 48 (T2) and 72 h (T3) after surgery, were acquired in specific software, and the discrepancies between them were studied in an accurate 3D volumetric method. We measured a significantly better edema trend in Group 1 in the tragus–nasal wing line and in the tragus–labial commissure line at T1, and also in the tragus–menton line at T2 and T3. In conclusion, Hilotherapy represents a more comfortable and more effective cryotherapy system in controlling the trend of facial edema after orthognathic surgery. The method we used for the facial scans is accurate, cheap, smart, and fast. As demonstrated by the 3D volumetric study of the face, the regions of the middle third of the face are those in which the difference is most noticeable.

Low-grade intraductal carcinoma is a rare neoplasia with an excellent prognosis, previously classified as low-grade cribriform cystadenocarcinoma and low-grade salivary duct carcinoma. The tumor mainly occurs in the parotid gland and presents a ductal phenotype and an intraductal/intracystic growth pattern. It resembles intraductal breast lesions such as atypical ductal hyperplasia, papillary and cribriform ductal carcinoma in situ. Despite its infrequency, discriminating low-grade intraductal carcinoma from other salivary gland tumors is crucial, especially because of its favorable prognosis. A 74-year-old woman with a history of neurofibromatosis underwent a superficial parotidectomy to remove a sharply demarcated multi-cystic mass, diagnosed as category 4 at FNAC. The histological examination revealed a demarcated but unencapsulated lesion composed of a bigger cyst surrounded by several smaller cysts, lined by a monolayer or bilayer epithelium alternated with a cribriform proliferation, characterized by “Roman-bridges”, with occasional micro-papillae. A myoepithelial component, with a basal disposition, was present, confirmed by intense staining for protein p63 and SMA. Immunohistochemical stains showed intense, strong uniform positivity for pan-cytokeratin, protein S100, and SOX10. The Ki67 proliferation index was low (< 10%). A diagnosis of Low-grade Intraductal Carcinoma (LGIC) of the parotid was made. We performed a literature search in PUBMED for “Intraductal carcinoma”, “Low-grade Intraductal Carcinoma”, “Cribriform Cystadenocarcinoma”, “Salivary Duct Carcinoma”, and “Low-Grade Salivary Duct Carcinoma”. We selected 17 papers published between 1983 and 2020; the most affected anatomical site was the parotid gland (77/90), followed by minor salivary glands (6/90), the intraparotid lymph nodes (3/90) and the submandibular gland (4/90). Their main histopathological features are reported in the paper. Here we present a case report and a review of scientific literature on this topic to provide some essential diagnostic tools to discriminate this rare entity.

Background In 1908 Sluder described a clinical picture of unilateral facial pain, lachrymation, rhinorrhea and mucosal congestion deriving from the Sphenopalatine Ganglion (SPG) irritation. We described a case of monolateral xerophthalmia, dry palate and mouth, deriving from SPG lesion after septoplasty that we called “SPG Deficit Syndrome”. Methods In our study a woman complaining functional nasal disorders and Computer Tomography (CT) images of a huge condro-vomerian septal spur in right nasal cavity, was underwent to septoplasty. After surgery she complained monolateral xerophthalmia, xerostomia and migraine. Results We formulated hypothesis of parasympathetic postgangliar nerve transmission interruption due to a lesion of effector fibers, supported by post-operative CT images of posterior wall of maxillary sinus lesion and by endoscopic evaluation of dryness of palatal mucosa and right nasal cavity. Conclusion To the best of our knowledge this is the first case of this kind of symptomatology reported as complication after septoplasty.

Our purpose was to investigate the spatial and temporal profile of the paraspinal muscle activation during gait in a group of 13 patients with lumbar instability (LI) in a pre-surgical setting compared to the results with those from both 13 healthy controls (HC) and a sample of 7 patients with failed back surgery syndrome (FBSS), which represents a chronic untreatable condition, in which the spine muscles function is expected to be widely impaired. Spatiotemporal gait parameters, trunk kinematics, and muscle activation were measured through a motion analysis system integrated with a surface EMG device. The bilateral paraspinal muscles (longissimus) at L3-L4, L4-L5, and L5-S1 levels and lumbar iliocostalis muscles were evaluated. Statistical analysis revealed significant differences between groups in the step length, step width, and trunk bending and rotation. As regard the EMG analysis, significant differences were found in the cross-correlation, full-width percentage and center of activation values between groups, for all muscles investigated. Patients with LI, showed preserved trunk movements compared to HC but a series of EMG abnormalities of the spinal muscles, in terms of left-right symmetry, top-down synchronization, and spatiotemporal activation and modulation compared to the HC group. In patients with LI some of such EMG abnormalities regarded mainly the segment involved by the instability and were strictly correlated to the pain perception. Conversely, in patients with FBSS the EMG abnormalities regarded all the spinal muscles, irrespective to the segment involved, and were correlated to the disease’s severity. Furthermore, patients with FBSS showed reduced lateral bending and rotation of the trunk and a reduced gait performance and balance. Our methodological approach to analyze the functional status of patients with LI due to spine disease with surgical indications, even in more complex conditions such as deformities, could allow to evaluate the biomechanics of the spine in the preoperative conditions and, in the future, to verify whether and which surgical procedure may either preserve or improve the spine muscle function during gait.