Francesco Benvegnù

Background: Reconstruction of the ventral skull base represents a challenge in head and neck surgery. When local or regional flaps are insufficient, microvascular free flaps offer a reliable reconstructive option. Methods: A systematic literature review was conducted following PRISMA guidelines to identify studies on ventral skull base reconstruction using microvascular free flaps. Eligible studies included cases with an explicit description of the flap type, recipient vessels, and transposition corridor. The authors propose a categorization of the surgical corridors used for pedicle transposition to optimize result interpretation. Results: Thirty‐seven studies encompassing 147 patients met inclusion criteria. A possible preferential association between site, corridor, and flap can be suggested. Conclusions: This study supports the role of a tailored selection of surgical corridors and recipient vessels in optimizing ventral skull base reconstruction. Moreover, it emphasizes the importance of matching anatomical feasibility with flap and patient's characteristics.

Air pollution (AP) is a critical environmental factor influencing public health, with well-documented associations with upper respiratory tract (URT) diseases. This study investigates the relationship between ENT emergency department (ENT-ED) visits at Azienda Ospedale Università di Padova (AOPD) and daily concentrations of environmental pollutants during the first year of the COVID-19 pandemic (March 2020–March 2021), compared to pre-pandemic data from 2017. The study focuses on patients diagnosed with URT inflammatory diseases, excluding those with COVID-19 infection, who sought care at the AOPD ENT-ED. Environmental data, including meteorological variables, air pollutants, and major aeroallergen levels, were collected from regional monitoring stations. A total of 4594 patients were admitted in 2020/2021, marking a 37% reduction from 2017, with URT inflammatory admissions decreasing by 52%. A significant decline in PM10, NO₂ and Alternaria levels was observed, whereas Betullaceae and Corylaceae concentrations significantly increased. Multivariate analyses revealed strong associations between aeroallergen exposure and ENT admissions, particularly for Alternaria, which had a notable impact on total admissions (p < 0.001) and was significantly linked to cases of otitis media and tonsillitis. PM10 concentrations on specific days preceding ED visits were associated with increased incidences of pharyngitis and rhinosinusitis (p < 0.05). These findings reinforce the connection between environmental pollutants and ENT emergency visits, highlighting the adverse effects of AP and climate variables on URT diseases, even during a pandemic when enhanced airway protection measures were in place. This study underscores the necessity of stringent air quality regulations and interdisciplinary strategies to mitigate environmental health risks and inform future public health policies.

Hearing loss in the elderly is a very common disease: it is estimated to affect up to a third of the population aged 65 years or more, and 50% of people over 75 years old. There is a growing amount of data concerning the association between hearing loss and cognitive decline. Various possible mechanisms at the basis of this association have been proposed, such as the “common cause hypothesis,” the “cascade hypothesis,” and the “cognitive load hypothesis.”Critically reviewing the data is essential to highlight the features of the relationship between hearing loss and cognitive decline. Most of the hearing tests available should take into account that dementia or even just mild cognitive impairment (MCI) may lead to poor performance during examination. On the other hand, clinicians should also remember that tests used to assess cognitive function require an adequate hearing capacity.In this article we propose to analyze current diagnostic tests, treatment options, auditory processing, and rehabilitation strategies for hearing loss in the elderly in order to facilitate the management of this handicap in this fragile population.