Corneal neurotization represents an effective surgical strategy to restore corneal sensibility in patients affected by neurotrophic keratopathy. Corneal sensibility is essential in preserving structure and function of the eye. Loss of corneal sensibility can lead to a degenerative condition of the cornea known as neurotrophic keratopathy. Moreover, patients suffering from facial palsy show failure of full eyelid closure resulting in chronic corneal exposure and subsequent progressive damage. Reports have shown that the use of the contralateral ophthalmic division of the trigeminal nerve can be effective in restoring corneal sensibility. In the present study the authors expose a new technique by means of which direct neurotization of the anesthetic cornea was achieved using the homolateral second division of the trigeminal nerve. Effectiveness of the technique was evaluated using in vivo confocal microscopy. To the best of authors’ knowledge, this is the first report of this technique in literature.

Schwannoma is a benign tumor that arises from nerves that contain Schwann cells. We report a case of giant schwannoma of the hard palate, which originated from the greater palatine nerve and is interesting for its large dimensions.

Objective: Lymphatic fistula is a complication that may occur in all cases where lymphostasis arise, due to a damage to the lymphatic drainage system. The current study evaluates the effectiveness of supramicrosurgical lymphaticovenular anastomosis (s-LVA) for treating lymphatic fistula. Patients and Methods: This is a retrospective study that aims to evaluate the effectiveness of s-LVA in treating lymphatic fistula. The inclusion criterion was the presence of persistent chronic lymphatic fistula; the exclusion criteria were refuse of the patient, terminal patients. All patients presented with lymphatic fistula. To evaluate lymphatic patency, indocyanine green (ICG) lymphography was performed in preoperative, immediately afterward and 1 month after s-LVA. Postoperative follow-up was performed for 1 year. The site for skin incision was selected on the basis of the ICG lymphography and the venous mapping. s-LVA was performed with 11-0 sutures using an operating microscope. Afterward, the skin incision was sutured with 6-0 absorbable sutures. Results: Eight patients (five males and three females) were enrolled in this study. Lymphatic vessels identified during s-LVA resulted ectasic. ICG lymphography demostrated patency of the anastomosis in all patients since the first postoperative day except one case, where the anastomosis resulted patent 1 month after s-LVA. No clinical complications were reported during the postoperative follow-up: no cellulitis and no recurrence of the fistula occurred in the year after s-LVA. Total recovery of fistula was observed and confirmed for the year after the intervention. Conclusions: This study evidenced positive results with lymphorrhea interruption and recovery of the fistula after the intervention.

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