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In the last decades a variety of innovative craniofacial approaches has been adopted to entire skull base. The endonasal endoscopic route has emerged as a suitable methodology for several skull base lesions. An effective watertight closure is essential to isolate the intracranial cavity in order to restore the natural intra and extradural compartment division, necessary to prevent postoperative cerebrospinal fluid (CSF) leakage and complications such as meningitis, brain herniation, and tension pneumocephalus. The reconstruction can be performed using different materials, both autologous (autologous grafts) and non-autologous, individually or combined in a multilayer fashion. The harvesting a nasoseptal flap is one of the most effective techniques: it reinforces the skull base closure granting isolation of the surgical field. The current study was focused on the development of new advanced devices and techniques, aiding in reducing postoperative CSF leak, which is one of the most feared complication of this surgical procedure. Additive manufacturing allows to design devices with tailored structural and functional features, in order to satisfy all the requirements. On the other hand, the development of injectable semi-IPNs and composites clearly benefits from specific mechanical/rheological and injectability studies. Accordingly, starting from some basic concepts, innovative principles and strategies were also proposed towards the design of additively manufactured and injectable devices.

Background Lung toxicity in patients undergoing cetuximab and radiotherapy (Cetux-RT) for head and neck squamous cell carcinoma (HNSCC) has been reported in literature and represents a serious side effect of concurrent therapies. Methods We report a case of a HNSCC patient that developed neck emphysema during the course of Cetux-RT. The patient was an old male (80 years old) in a good performance status, with an oropharyngeal cancer (T4aN3a). Results During RT, cone-beam computed tomography (CBCT) showed bilateral neck emphysema that was confirmed at restaging CT. We decided to stop the treatment and to treat the neck emphysema with conservative strategies. After one week CT was repeated and the neck emphysema had improved, so we decided to complete the RT treatment. Conclusions Patients undergoing Cetux-RT must be properly selected, whereas IGRT imaging must be viewed carefully in order to permit an early diagnosis and careful management of the patients.

Management of patients with head and neck cancers (HNCs) is challenging for the Radiation Oncologist, especially in the COVID-19 era. The Italian Society of Radiotherapy and Clinical Oncology (AIRO) identified the need of practice recommendations on logistic issues, treatment delivery and healthcare personnel’s protection in a time of limited resources. A panel of 15 national experts on HNCs completed a modified Delphi process. A five-point Likert scale was used; the chosen cut-offs for strong agreement and agreement were 75% and 66%, respectively. Items were organized into two sections: (1) general recommendations (10 items) and (2) special recommendations (45 items), detailing a set of procedures to be applied to all specific phases of the Radiation Oncology workflow. The distribution of facilities across the country was as follows: 47% Northern, 33% Central and 20% Southern regions. There was agreement or strong agreement across the majority (93%) of proposed items including treatment strategies, use of personal protection devices, set-up modifications and follow-up re-scheduling. Guaranteeing treatment delivery for HNC patients is well-recognized in Radiation Oncology. Our recommendations provide a flexible tool for management both in the pandemic and post-pandemic phase of the COVID-19 outbreak. Electronic supplementary material The online version of this article (10.1007/s12032-020-01409-2) contains supplementary material, which is available to authorized users.

The concept of magnetic guidance has opened a wide range of perspectives in the field of tissue regeneration. Accordingly, the aim of the current research is to design magnetic responsive scaffolds for enhanced bone tissue regeneration. Specifically, magnetic nanocomposite scaffolds are additively manufactured using 3D fibre deposition technique. The mechanical and magnetic properties of the fabricated scaffolds are first assessed. The role of magnetic features on the biological performances is properly analyzed.