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Various techniques for local flap reconstructions of the facial region have been documented in the literature, including the advancement flap. This flap is one of the most versatile options for reconstructing various skin defects across different areas of the body. The purpose of this study is to demonstrate the safety and effectiveness of the advancement flap for reconstructing the paralateronasal region after the excision of skin cancer. The following article presents a retrospective case series of 6 patients in whom the advancement flap was used to reconstruct skin defects resulting from malignant tumor resections in the paralateronasal region. No restrictions were collected regarding etiology, location, size, age, sex, or any other patient factors. The recruited patients were treated in the Maxillofacial Surgery Unit of Floraspe Renzetti Hospital of Lanciano, and the study was conducted in collaboration with Sapienza University of Rome, from February 2023 to February 2024. All the flaps settled with no complications, and all the patients were FOD (free of disease) 6 months after surgery. So, in accordance with the literature, the advancement flap turns out to be a rapid and reliable option that could be easily applied for cutaneous defects of the face even for the oldest and/or emaciated patient., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Several local skin flaps and tissue rearrangement techniques have been described in the literature, including the rhomboid flap. The Limberg flap is one of the most versatile local flaps that can be used for reconstruction of a wide range of skin defects in different parts of the body. The purpose of this study is to demonstrate the safety and applicability of the Limberg flap for reconstruction of skin facial defects, particularly after cutaneous tumor resection. The following article presents a retrospective case series of 8 patients in whom the Limberg flap was used to reconstruct skin defects resulting from malignant tumor resections in the lateral part of the face. No restrictions were collected regarding etiology, location, size, age, sex, or any other patient factors. The recruited patients were treated in the Maxillofacial Surgery Unit of Floraspe Renzetti Hospital of Lanciano and the study was conducted in collaboration with Sapienza University of Rome, from April 2023 to April 2024. All the flaps settled with no complications and all the patients were FOD (free of disease) 6 months after surgery. So, in accordance with the literature, the Limberg flap turns out to be a rapid and reliable option that could be easily applied for small (size around 1-2 cm) and medium-sized (size around 2-4 cm) cutaneous defects of the face even for the oldest and/or emaciated patients., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: Airbags have significantly decreased fatalities in frontal vehicle accidents, but their deployment can lead to more severe injuries and rarely death. The authors present a case of a penetrating injury causing tissue loss in the left cheek, an "explosion" of the zygomatic arch, and facial nerve damage, discussing the management in the contest of literature examining similar injuries in the head and neck region., Materials and Methods: Reviewing English literature from 1995 to 2023, 9 patients experienced severe airbag-related penetrating head and neck injuries, in 3 cases resulting in death. In addition, we describe the case of a young male reporting a deep cheek laceration with facial nerve damage, tissue loss, and comminuted maxilla-zygomatic fracture; 48 hours after trauma, he underwent surgical reconstruction using a bilobed flap, direct suture of the resected masseter muscle, closed reduction of the comminuted zygomatic arch fracture, and direct neurorrhaphy of the lacerated facial nerve., Results: Five months after surgery, facial nerve function recovery was observed. Mouth opening was restored, but a mixed low-medium hearing loss persisted for high frequencies. In another case marginal nerve damage was reported, but management is not described., Conclusion: The use of seat belts and airbags has led to a significant reduction in the incidence of facial fractures and fatalities after motor vehicle accidents, but at the same time, in some cases, complex facial trauma and/or penetrating injury can be observed. In case of suspected or certain facial nerve damage, it is mandatory to perform exploration and eventual reconstruction within 72 hours., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Objectives : This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods : The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results : A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions : This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.

The main causes of injuries to the lower and middle third of the facial skeleton are traffic accidents, accidental falls, assaults, and sport. Regarding sports-related maxillofacial trauma, an 8-year retrospective study was conducted at the Department of Oral and Maxillofacial Surgery of the Policlinico Umberto I in Rome, Italy. In all, 329 patients were included, of which we analyzed 35 patients with sports-related mandibular fractures. Specifically, we assessed the type of mandibular fracture reported, age, gender, number of fracture lines, association with other maxillofacial fractures, and treatment options. The causes of sports-related injuries are often multifactorial. Therefore, the aim of our study was to understand the correlation between the type of sport practiced and the most frequently reported pattern of mandibular fracture, highlighting how, depending on the sport, the mechanism of action is different and may correlate with a specific type of mandibular fracture., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Introduction: Shared vehicles, such as e-scooters and electric bicycles, could potentially accelerate the transition toward sustainable mobility. Focusing on e-scooters, the aim of this study is to show, compared with previous years when e-scooter use was significantly reduced, the increased incidence of maxillofacial bone injuries from e-scooters and the most frequent type of fractures., Methods: We conducted a monocentric observational retrospective and prospective analysis during the pandemic, from January 1, 2020, until December 31, 2022, on patients' access for maxillofacial traumas at the San Giovanni Addolorata emergency department, trauma hub center, for Lazio district. A total of 383 patients were included. Data on the causes of traumas, type of injury produced, age, gender, nationality, and helmet use were collected. Especially, we analyzed the e-scooter-related facial traumas that had gained a lot of popularity in this period due to the restriction in mobility because of Covid-19, subsequent reduced use of public transport, and the new benefits introduced by the government for e-scooters or bikes. We compared e-scooter facial trauma with all the other kinds of facial fracture etiologies during this period., Results: In our study, the most frequent causes of trauma were assaults (32.6%), accidental falls (24.2%), and sports activities (7.8%). The percentage of trauma among road traffic injuries was almost 24% of the total; in particular, motorcycle/e-scooter traumas was 7.1%, car crashes was 5.5%, pedestrian hits was 4.2%, and bike accidents was 3.1%. Other causes detected were syncope (5.5%), accidental traumas (1.8%), and epileptic crisis (1.1%). Focusing on road traffic injury access in our emergency department, compared with those between 2017 and 2019, it emerged that e-scooter-related facial traumas in the past two years have had a remarkable rise. In fact, there was a total of 27 patients (52% male and 48% female) instead of 5 between 2017 and 2019. The average age was 29 years. The most frequent types of e-scooter-related fractures were those to the nasal bones (29.7%), followed by mandibular fractures (unifocal 7.4%, bifocal 18.5%, trifocal 7.4%, and condylar 7.4%), zygomatic-maxillo fractures (18.4%), complex fractures (7.4%), and maxilla (3.7%). Among 27 observed electric scooter riders, nobody wore a helmet., Conclusions: Injuries associated with the use of e-scooters are a new phenomenon and mainly affect the craniofacial region due to the dynamic nature of the trauma. Although these vehicles have become increasingly common over the years and accepted within regulatory frameworks, the traffic rules are not ready to integrate e-scooters into the transport systems due to the lack of adequate legislation, and the lack of implementation in the form of facial safety devices or safety skills training for e-scooter riders., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)