We examined the prognosis of super elderly patients undergoing surgery for facial skin cancer. All patients were hospitalized and all surgeries were performed under local anesthesia. Eleven surgeries were performed for 11 patients aged over 90 years old with facial skin cancer. The patient population consisted of six men and five women, with a mean age of 93 years old；36.4% had dementia, 36.4% used antithrombotic drugs, and 45.5% were receiving nursing care. The histological types of cancer were squamous cell carcinoma（SCC）in 64% and basal cell carcinoma（BCC）in 36%. The resection margin was negative in all patients. The method of resurfacing was local flap in 64% and full-thickness skin graft in 36%. At the 19-month follow-up, nine patients were alive without recurrence of skin cancer and one patient had died due to sepsis caused by burn. Although skin cancer recurred in one patient, she is still alive and receiving radiation therapy. The incidence of facial skin cancer among elderly people is increasing, but there is no treatment protocol. Therefore, tailored therapy is expected. Excellent treatment outcomes are required for elderly patients with facial skin cancer.

　　Orbital wall fractures are caused mainly by bruising of the orbital areas, and are roughly divided into those with or without orbital rim fracture, or by type, punch-out or linear. Symptoms are primarily enophthalmos and ocular movement disorder, and surgical treatment is performed in cases in which symptomatic improvement cannot be obtained by conservative treatment. The surgical indications are muscle entrapment and moderate or severe ocular depression. However, not all patients presenting with double vision at the initial examination have orbital wall fractures. Therefore, bleeding and swelling or edema of the orbital area may impair vision, and be subacute symptoms that disappear spontaneously. Time course image diagnosis is helpful to decide the correct management.
　　In this report, we describe a 5-year statistical study performed at our unit, and a strategy for orbital wall fractures, including those with rim and apex injuries, illustrating its diagnosis, decision on emergency or stand-by operation, and its procedure.

　　Sphenoid bone fractures associated with the medial transposition of a zygomatic bone fracture are not rare. The force used during open reduction of a zygomatic bone fracture may extend to the orbital apex and site of the sphenoid bone fracture. We report four cases of zygomatic bone fracture associated with a sphenoid bone fracture.
　　The approaches for Case 1 and Case 2 were different, but good reposition was achieved in both because a wide operative field enabled good reduction with no effects on the sphenoid bone fracture. However, Case 3 had associated sphenoid and frontal bone fractures, and intracranial hematoma. Good reduction was not achieved because of the brain complication. Good results using a general approach were achieved in Case 4, which had associated sphenoid bone and skull base fractures.
　　We perform simulation surgery to consider the approach and reduction methods prior to actual surgical repair of the zygomatic bone. During the actual surgery, we confirm the bone fracture line of the sphenoid bone directly, and reduction can be performed safely in some cases by adding osteotomy of the lateral orbital wall.

　　Voriconazole is a widely used and highly effective azole antifungal agent. Its associated adverse events include liver damage and abnormal vision. Photosensitivity may also develop in some patients. A 73-year-old woman developed malignant lymphoma approximately 9 years earlier, and had been in remission after chemotherapy and hematopoietic stem cell transplantation. She had been taking 200 mg/day of voriconazole to treat pneumomycosis for approximately 3 years and 8 months. Around the summer of 2017, erythema was noted on the face and an elevated lesion developed on the left cheek. Therefore, she was referred to the department of dermatology. Tissue biopsy of the elevated lesion demonstrated squamous cell carcinoma, but no metastases were found by whole-body search. Thereafter, she developed recurrent squamous cell carcinomas of the face and both hands, underwent multiple surgical resections, chemotherapies, and treatments using topical products, and her symptoms improved. The mechanism of voriconazole-induced skin carcinogenesis is unknown. However, experimentally, the antifungal agent exhibits phototoxic effects in a concentration-dependent manner. Therefore, it is important that patients taking voriconazole be instructed to carefully protect exposed areas from sunlight, and be followed-up regarding photosensitivity symptoms.

　　A 48-year-old woman presented with a several-year history of bilateral painful swelling on her forehead. Computed tomography revealed osteolytic lesions with dot-like high-density areas on both sides of the frontal bone. Based on these characteristic findings, the patient was diagnosed with venous malformations. En bloc resection of these lesions, including the perilesional bone, was performed. Following resection of the lesions, residual bone defects were reconstructed using autologous bone harvested from the parietal bone.
　　Histopathological examination confirmed that the bilateral frontal bone lesions were venous malformations. No recurrence of the cranial deformity or resorption of bone grafts was observed 2 years postoperatively.
　　Primary intraosseous venous malformations are uncommon and account for 0.7% to 1.0% of all bone neoplasms. Lesions involving the cranial vault are rare, constituting only 0.2% of all bone tumors. Although the frontal bone is a common site of intraosseous venous malformations, multiple lesions involving the skull are unusual. In this patient, we successfully used autologous bone as reconstruction material to reduce the risk of infection.