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Levine M, Noel OF, Patel S, Park H, Weller CL, Lighthall JG. An unusual presentation of orbital encephalocele following a self-inflicted gunshot wound injury: A case report and literature review. Clin Case Rep 2024; 12:e9115. [PMID: 39091615 PMCID: PMC11291299 DOI: 10.1002/ccr3.9115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/04/2024] [Accepted: 06/13/2024] [Indexed: 08/04/2024] Open
Abstract
While orbital encephaloceles secondary to orbital roof fractures, in the setting of gunshot wound injuries, are rare, it is important to discuss diagnosis, treatment, and outcomes. This comprehensive manuscript aims to accomplish these objectives.
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Affiliation(s)
- Marc Levine
- Penn State Hershey College of MedicinePenn State Milton S. Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Olivier F. Noel
- Division of Plastic and Reconstructive Surgery, Department of SurgeryYale University School of MedicineNew HavenConnecticutUSA
| | - Shivam Patel
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of PittsburgPittsburgPennsylvaniaUSA
| | - Haejoe Park
- Department of Neurosurgery, Penn State College of MedicinePenn State Milton S. Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Christopher L. Weller
- Department of OphthalmologyPenn State Health Milton S. Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Jessyka G. Lighthall
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck SurgeryPenn State College of Medicine, Penn State Milton S. Hershey Medical CenterHersheyPennsylvaniaUSA
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Stanbouly D, Chuang SK. What Factors Influence the Hospitalization of Self-Inflicted Craniomaxillofacial Gunshot Wounds? Craniomaxillofac Trauma Reconstr 2023; 16:167-179. [PMID: 37975023 PMCID: PMC10638971 DOI: 10.1177/19433875221094975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Study Design The following retrospective cohort study was competed using data from the Nationwide Inpatient Sample a database from the Healthcare Cost and Utilization Project (HCUP). Objective The objective of this retrospective cohort study is to compare the hospitalization outcomes of managing maxillofacial trauma attempted suicide among handguns, shotguns, and hunting rifles. Methods The primary predictor variable was the type of firearm. The outcome variables were the hospital charges (U.S. dollars) and length of stay (days). We used SPSS version 25 for Mac (IBM Corp., Armonk, NY, USA) to conduct all statistical analyses. Results A final sample of 223 patients was statistically analyzed. Relative to patients within the Q2 median household income quartile, patients in the Q4 median household income quartile added +$ 172'609 (P < .05) in hospital charges. Relative to patients living in "central" counties of metro areas, patients in micropolitan counties added +13.18 days (P < .05) to the length of stay. Relative to patients in the Q2 median household income quartile, patients in Q3 added +9.54 days (P < .05) while patients in Q4 added +11.49 days (P < .05) to the length of stay. Conclusions Being within the highest income quartile was associated with increased hospital charges. Patients living in micropolitan counties have prolonged hospitalization relative to patients in metropolitan counties. Relative to the second income quartile, length of stay was higher in the third income quartile and highest in the fourth income quartile. Increase income grants access to deadlier firearms.
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Affiliation(s)
- Dani Stanbouly
- Columbia University College of Dental Medicine, New York, NY, USA
| | - Sung-Kiang Chuang
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Brockton Oral and Maxillofacial Surgery Inc., Brockton, MA, USA
- Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA, USA
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
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3
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Wamkpah NS, Kimball A, Pipkorn P. Evidence-Based Medicine for Ballistic Maxillofacial Trauma. Facial Plast Surg 2023; 39:237-252. [PMID: 36929067 DOI: 10.1055/s-0043-1764347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Ballistic trauma is a serious health issue with significant costs to physical, psychosocial, economic, and societal well-being. It may be caused from firearms, explosive devices, or any other projectile forces, and is characterized by severe tissue loss and evolving tissue devitalization. This review covers mechanism, diagnosis, and management of ballistic maxillofacial trauma, specifically. Initial evaluation includes stabilization of airway, bleeding, and circulation, followed by assessment of other injuries. The overall degree of tissue damage is determined by intrinsic patient factors and extrinsic projectile factors. Management of ballistic injuries has shifted toward advocation for early operative repair with the advent of antibiotics and advanced techniques in maxillofacial reconstruction. Appropriate timing and method of reconstruction should be carefully selected on a case-by-case basis. While ballistic trauma research is limited to studies biased by institutional practices, areas for further study identified from current literature include guidelines directing timing of reconstructive surgery; thresholds for free tissue transfer; handling of retained projectiles; incidence of surgical complications; and clinical outcomes for computer-aided surgical repair of these highly destructive injuries.
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Affiliation(s)
- Nneoma S Wamkpah
- Department of Otolaryngology, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Abby Kimball
- InPrint, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Patrik Pipkorn
- Department of Otolaryngology, Washington University in St Louis School of Medicine, St Louis, Missouri
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Qaisi M, Martin S, Al Azzawi T, Aldelayme R, Bokhari F, Murphy J. Is Maxillofacial Gunshot Wound Location Associated With Operative Intervention? J Oral Maxillofac Surg 2022; 81:434-440. [PMID: 36592933 DOI: 10.1016/j.joms.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Gunshot wound (GSW) injuries are an important public health concern in the United States. The study purpose was to measure the association between GSW location and need for operative treatment. METHODS This was a retrospective cohort study. Sample consisted of all patients treated for maxillofacial gunshot wound injuries at Cook County Health from 2008 to 2018. The sample data were collected through a retrospective charts review and review of computed tomography imaging. The predictor variable was the region of the face involved with the GSW and it was divided into 3 levels, upper face (UF), middle face (MF), and lower face (LF). The outcome variable was whether operative intervention was rendered or not (operative vs no intervention). Other variables of interest collected included patient demographics, the type of surgical intervention, disposition (home vs rehab/morgue), rate of intracranial injury, and need for blood transfusion. Data analysis was performed using Chi-square for proportions and relative risk (RR) with 95% confidence interval (CI). RESULTS A total of 180 patients were identified to have sustained GSW injuries to the face during abovementioned time frame. Of those, 120 patients had isolated GSW injuries with no other organs involvement. The median age was 25 years. Majority of the patients were males (94%). The involved facial region appeared to influence the need for operative management and this reached statistical significance (Chi-square 22.703, P < .001). GSW injuries to LF were 2.94 times more likely to require operative intervention than injuries to the MF (RR = 2.94, 95% CI = 1.625-5.327). Injuries of the UF were 2 times more likely to require operative intervention than injuries of the MF (RR = 2.03, 95% CI 1.023-4.008). Injuries to the UF were more likely to be associated with intracranial injuries (Chi-square = 20.522, P < .001). CONCLUSIONS In patients with facial GSW injuries, there is an association between injury location and the need for operative intervention. Injuries to the LF were most likely to require surgical intervention followed by the UF and MF, respectively.
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Affiliation(s)
- Mohammed Qaisi
- Professor of Oral and Maxillofacial Surgery, Midwestern University and Program Director, Division of Oral and Maxillofacial Surgery, Cook County Health, Chicago, IL.
| | - Stephen Martin
- Oral and Maxillofacial Surgery, Cook County Health, Chicago, IL
| | - Thaer Al Azzawi
- Research Fellow, Division of Oral and Maxillofacial Surgery, Cook County Health, Chicago, IL
| | - Raed Aldelayme
- Research Fellow, Division of Oral and Maxillofacial Surgery, Cook County Health, Chicago, IL
| | - Faran Bokhari
- Director Department of Trauma/Burn Surgery and Rehabilitation, Cook County Health, Chicago, IL
| | - James Murphy
- Associate Professor (MWU), Division of Oral and Maxillofacial Surgery, Cook County Health, Chicago, IL
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Predictors of Infection and Benefit of Antibiotics in Gunshot Wounds to the Face. Ann Plast Surg 2022; 89:517-522. [PMID: 36279576 DOI: 10.1097/sap.0000000000003284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gunshot wounds (GSWs) to the face are at high risk for infection due the extent of tissue injury and often-observed violation of oral and sinus cavities. Given the ambiguous data on antibiotic benefit in GSW to the face, the purpose of this study is to characterize antibiotic usage, infection details, and risk factors associated with higher infection rates in GSW to face. METHODS We conducted a retrospective review of patients presenting with GSW to the face from 2009 to 2017. The primary outcome was to identify risk factors associated with infections in patients with facial GSWs. A stepwise multivariate linear regression analysis was performed to determine the impact of specific injury details. RESULTS Two hundred sixty-nine patients qualified for the study. Demographic information and details of hospital stay are presented in tables. Most patients (88.8%) received admission antibiotics. Facial infections were observed in 36 patients (13.4%). The infected cohort required more antibiotic days (P < 0.001), higher percentage of invasive airway procedures (P = 0.01), longer length of stay (P < 0.001), greater number of surgeries (P < 0.022), and higher readmission rates (P < 0.001). Factors associated with head or neck infections included oral cavity (odds ratio, 1.23; P = 0.04) and sinus involvement (odds ratio, 1.10; P = 0.045). CONCLUSIONS Bullet trajectories that violated the oral or maxillary sinus cavities were associated with higher head and neck infection rates. Patients without oral cavity or sinus involvement had a lower chance (4.1%) of developing an infection and therefore may have marginal benefit from antibiotics.
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Airway management in self-inflicted gunshot wounds to the face. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Knudson SA, Day KM, Kelley P, Padilla P, Collier IX, Henry S, Harshbarger R, Combs P. Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review. Craniomaxillofac Trauma Reconstr 2022; 15:206-218. [PMID: 36081679 PMCID: PMC9446274 DOI: 10.1177/19433875211026432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Abstract
Study Design Retrospective case series; systematic review. Objective It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.
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Affiliation(s)
- Sean A. Knudson
- Division of Craniofacial and Pediatric
Plastic Surgery, Dell Children’s Medical Center, The University of Texas at Austin,
Austin, TX, USA
| | - Kristopher M. Day
- Division of Craniofacial and Pediatric
Plastic Surgery, Dell Children’s Medical Center, The University of Texas at Austin,
Austin, TX, USA
- Department of Plastic Surgery, Dell
Seton Medical Center, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School, The University of
Texas at Austin, Austin, TX, USA
| | - Patrick Kelley
- Division of Craniofacial and Pediatric
Plastic Surgery, Dell Children’s Medical Center, The University of Texas at Austin,
Austin, TX, USA
- Department of Plastic Surgery, Dell
Seton Medical Center, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School, The University of
Texas at Austin, Austin, TX, USA
| | - Pablo Padilla
- Department of Plastic Surgery,
University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Ian X. Collier
- Dell Medical School, The University of
Texas at Austin, Austin, TX, USA
| | - Steven Henry
- Department of Plastic Surgery, Dell
Seton Medical Center, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School, The University of
Texas at Austin, Austin, TX, USA
| | - Raymond Harshbarger
- Division of Craniofacial and Pediatric
Plastic Surgery, Dell Children’s Medical Center, The University of Texas at Austin,
Austin, TX, USA
- Department of Plastic Surgery, Dell
Seton Medical Center, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School, The University of
Texas at Austin, Austin, TX, USA
| | - Patrick Combs
- Division of Craniofacial and Pediatric
Plastic Surgery, Dell Children’s Medical Center, The University of Texas at Austin,
Austin, TX, USA
- Department of Plastic Surgery, Dell
Seton Medical Center, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School, The University of
Texas at Austin, Austin, TX, USA
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Facial Reconstruction Following Self-Inflicted Gunshot Wounds: Predictors, Complications, and Acceptable Outcomes. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Self-inflicted gunshot wounds (SIGSWs) produce devastating facial defects that are challenging to reconstruct, but are rarely reported in large cohorts in the literature. This study sought to characterize these injuries, and identify parameters influencing complications and outcomes among survivors following facial reconstruction. Methods: A retrospective cohort study was performed identifying 22 patients with SIGSWs to the face reconstructed at our center from 2009 to 2019. Charts were reviewed for patient, injury, and reconstructive details and course. Outcomes were statistically compared to various parameters. Results: The most common firearm, orientation, and injured structure were the handgun (40.9%), submental (59.1%), and mandible (68.2%), respectively. Patients averaged a 21.7-day length of stay (LOS), 17.4 h to debridement, 2.6 days to bony fixation, 5.4 reconstructive surgeries, and 7 (31.8%) patients received at least one free flap. Fifteen (68.2%) patients had at least one major complication, although functional outcomes were ultimately relatively good overall. Notable outcome associations included submental orientation with a longer LOS (p = 0.027), external fixation with a longer LOS (p = 0.014), financial stressors with a shorter LOS (p = 0.031), and severe soft tissue injury with an increased total number of reconstructive surgeries (p = 0.039) and incomplete reconstruction (p = 0.031). There were no cases of suicidal recidivism. Conclusions: Reconstruction following facial SIGSW is challenging for both patient and surgeon, and carries a high rate of complications. However, patients can regain substantial function following reconstruction and the achievement of satisfactory outcomes.
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Survival Following Self-Inflicted Gunshot Injuries to the Face Using the National Trauma Data Bank. J Craniofac Surg 2021; 32:2064-2067. [PMID: 33770041 DOI: 10.1097/scs.0000000000007634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Self-inflicted gunshot wounds to the face frequently result in devastating injuries; however, there is a paucity of large experiences describing determinants of mortality and outcomes. METHODS Using the National Trauma Databank from 2007 to 2015, patients suffering self-inflicted firearm facial injuries were included. RESULTS Over 9 years 7869 patients were included: 87.7% were male, 46.4% suffered traumatic brain injury (TBI) and overall in-hospital mortality was 44.7%. The majority (67.8%) of in-hospital mortality occurred within the first 24 hours. Using multiple regression, advanced age (>65 years), presence of TBI, admission hypotension, and decreased Glasgow coma score were each independently associated with increased odds of mortality (all P < 0.001). Mandible or combined mandible/midface fracture injury patterns were most likely to survive (P < 0.001). Of those surviving to hospital discharge, the median [interquartile range] length of stay was 13 [6, 23] days, 86.6% required an intensive care unit stay with 67% requiring intubation and 42.5% tracheostomy. Among survivors, the combined mandible and midface fracture pattern resulted in the highest rates of tracheostomy (70.5%), gastrostomy tube placement (50.5%), and facial operations (87.0%) with a median [interquartile range] of 5 [3, 7] operative trips (all P < 0.001). CONCLUSIONS Self-inflicted facial firearm injuries are highly morbid injuries with the majority of in-hospital deaths occurring the first hospital day. Differences including concomitant TBI, facial injury pattern, neurologic status, and presence of hypotension on admission were independently associated with survival/death. More extensive facial injuries (combined mandible and midface fracture patterns) were more likely to survive and required more intensive interventions.
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Momeni Roochi M, Razmara F. Maxillofacial gunshot injures and their therapeutic challenges: Case series. Clin Case Rep 2020; 8:1094-1100. [PMID: 32577273 PMCID: PMC7303870 DOI: 10.1002/ccr3.2827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/29/2022] Open
Abstract
Maxillofacial gunshot injuries require proficiency to determine a suitable treatment plan and surgical intervention. In this paper, present 4 gunshot cases. Treatment in these patients is very challenging. Moreover, post-treatment infections are a serious problem in such cases. Thus, step-by-step surgery is essential to obtain a better result in these patients.
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Affiliation(s)
| | - Farnoosh Razmara
- Department of Maxillofacial SurgeryTehran University of Medical SciencesTehranIran
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Pawsey SC, Wilson CG, Gunther WM, Fantaskey AP. Suicide by Close-Range Gunshot Wound to the Bridge of the Nose. J Forensic Sci 2019; 65:984-986. [PMID: 31651989 DOI: 10.1111/1556-4029.14221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 11/28/2022]
Abstract
Suicidal gunshot wounds to the nasal bridge are rare, particularly at close range (defined as muzzle of the weapon not touching the skin surface, but near enough to deposit soot and stippling). Previously reported suicidal gunshot wounds to the nose have been through the left nostril (Forensic Sci Int 1995;71(1):25-31; J Forensic Radiol Imag 2013;1(2):63-7). The death of a 26-year-old man with a close-range gunshot wound to the bridge of the nose was deemed suicide due to history, scene, and autopsy findings. These findings included previous suicidal ideation, texted and written notes, the decedent's cross-legged position seated on the floor, the trajectory of the bullet through his head and into the ceiling fan and roof above him, and acute alcohol intoxication. This decedent may have been intending a hard contact forehead location but inadvertently fired the gun into the bridge of his nose while bending forward, prior to contact.
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Affiliation(s)
- Sydney C Pawsey
- Physician Assistant Program, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501
| | - Catherine G Wilson
- Doctor of Medicine Program, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501
| | - Wendy M Gunther
- Tidewater District, Commonwealth of Virginia, Office of the Chief Medical Examiner, 830 Southampton Avenue, Ste. 100, Norfolk, VA, 23510
| | - Amy P Fantaskey
- Physician Assistant Program, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501
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Abstract
The management of victims of gunshot fractures is a challenge for surgeons, mainly due to the complexity of the injury itself and degree of bone comminution. The titanium functionally dynamic bridging plate has often been used in reconstructive surgery after mandibular fractures. The classic indication for bridge plate use is comminuted fractures with or without associated substance losses. The aim of this article is report the case of gunshot victim and to discuss the bridge plate technique utilized for treatment. A 21 years-old, melanoderma, male patient was victim of a firearm-related assault, with comminutive fracture of the mandibular body. The protocol for the bridging plate technique was performed. The patient is in postoperative follow-up of eight months, not present aesthetic or functional complaints, stable occlusion, satisfactory mouth opening and no clinical signs of infection.
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Maia ABP, Assis SG, Ribeiro FML, Pinto LW. The marks of gunshot wounds to the face. Braz J Otorhinolaryngol 2019; 87:145-151. [PMID: 31540871 PMCID: PMC9422606 DOI: 10.1016/j.bjorl.2019.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction This article deals with the occurrence of health problems due to gunshot wounds to the face among military police officers, in the metropolitan region of Rio de Janeiro, who were submitted to surgery at the Oral and Maxillofacial Surgery and Traumatology Clinic of Hospital Central da Polícia Militar. Objective To identify the profile of patients submitted to surgery as a result of gunshot wounds, the anatomical distribution of maxillofacial fractures, the identified sequelae and complications, the health specialties involved in the rehabilitation of these patients, and to discuss the social, emotional and work performance-related effects of work among these subjects. Methods A retrospective epidemiological study was carried out based on secondary data from military police officers who were submitted to surgery at Hospital Central da Polícia Militar due to gunshot wounds from June 2003 to December 2017. Results During the study period, 778 surgeries were performed in the operating room by the Oral and Maxillofacial Surgery and Traumatology service at Hospital Central da Polícia Militar, 186 of which were due to gunshot wounds (23.9%). All patients were males and the mean age 34.7 years. Bone segment loss was the most common sequela. Facial esthetic impairment and reports of insomnia were the most often identified late consequences of impact on health and social life. Regarding the occupational impacts of the sustained injury, the mean time away from work due to medical leave for the treatment of maxillofacial injuries was 11.7 months. Conclusion The treatment of gunshot wounds patients with facial injuries requires multiple surgical interventions and their rehabilitation requires the involvement of different health specialties. Further studies are needed to qualitatively analyze the impact of this type of facial trauma on the patients' lives and their social consequences.
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Affiliation(s)
- Adriane Batista Pires Maia
- Colégio Brasileiro de Cirurgia e Traumatologia Bucomaxilofacial, São Paulo, SP, Brazil; Escola Nacional de Saúde Pública da Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Departamento Latino-Americano de Estudos de Violência Sérgio Carelli, Rio de Janeiro, RJ, Brazil; Hospital Central da Polícia Militar do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Simone Gonçalves Assis
- Escola Nacional de Saúde Pública da Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Departamento Latino-Americano de Estudos de Violência Sérgio Carelli, Rio de Janeiro, RJ, Brazil
| | - Fernanda Mendes Lages Ribeiro
- Escola Nacional de Saúde Pública da Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Departamento Latino-Americano de Estudos de Violência Sérgio Carelli, Rio de Janeiro, RJ, Brazil
| | - Liana Wernersbach Pinto
- Escola Nacional de Saúde Pública da Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Departamento Latino-Americano de Estudos de Violência Sérgio Carelli, Rio de Janeiro, RJ, Brazil
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Haller I, Lederer W, Glodny B, Wiedermann FJ. Severe Craniofacial Trauma After Multiple Pistol Shots. Open Med (Wars) 2019; 14:629-632. [PMID: 31535034 PMCID: PMC6731541 DOI: 10.1515/med-2019-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/16/2019] [Indexed: 11/27/2022] Open
Abstract
A 48-year-old woman suffered from life-threatening injuries in head and chest caused by six pistol shots fired at close range in an attempted homicide. We report here on our successful airway management and bleeding control at the scene of crime and the multidisciplinary surgical treatment of the associated head and neurovascular injuries.
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Affiliation(s)
- Ingrid Haller
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Wolfgang Lederer
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Bernhard Glodny
- Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Franz J Wiedermann
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Masumbuko Mukamba F, Cikomola F, Muhindo L, Kabuya P, Balungwe P, Maheshe Balemba G, Kuyigwa G, Ahuka Ona Longombe A, Reychler H. The outcome of pectoralis major myocutaneous flap in the reconstruction of large defects in the lower face region after high velocity gunshot injury in the eastern part of DR Congo. ANN CHIR PLAST ESTH 2019; 65:166-170. [PMID: 31345589 DOI: 10.1016/j.anplas.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/04/2019] [Indexed: 11/16/2022]
Affiliation(s)
- F Masumbuko Mukamba
- Département de chirurgie, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo.
| | - F Cikomola
- Département de chirurgie, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - L Muhindo
- Département de chirurgie, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Kabuya
- Département d'anesthésie et réanimation, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Balungwe
- Département d'ORL, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - G Maheshe Balemba
- Département de radiologie, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - G Kuyigwa
- Département de chirurgie, université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - A Ahuka Ona Longombe
- Département de chirurgie, université de Kisangani, Bukavu, Democratic Republic of the Congo
| | - H Reychler
- Service de stomatologie et chirurgie maxillofaciale, université Catholique de Louvain, Brussels, Belgium
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Sacks CA, Kamalian S, Masiakos PT, Alba GA, Patalas ED. Case 31-2018: A 37-Year-Old Man with a Self-Inflicted Gunshot Wound. N Engl J Med 2018; 379:1464-1472. [PMID: 30304661 DOI: 10.1056/nejmcpc1807500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Chana A Sacks
- From the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Harvard Medical School - both in Boston
| | - Shahmir Kamalian
- From the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Harvard Medical School - both in Boston
| | - Peter T Masiakos
- From the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Harvard Medical School - both in Boston
| | - George A Alba
- From the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Harvard Medical School - both in Boston
| | - Eva D Patalas
- From the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Massachusetts General Hospital, and the Departments of Medicine (C.A.S., G.A.A.), Radiology (S.K.), Surgery (P.T.M.), and Pathology (E.D.P.), Harvard Medical School - both in Boston
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