Snookered! Facial infection secondary to occult foreign body

Scratch…Descriptive epidemiologic study of billiards-related injuries

The purpose of this descriptive epidemiological study is to identify billiards-related injuries that presented to the United States emergency departments from 2000 to 2020. This is a study using secondary data from emergency departments from 2000 to 2020 and presented with billiards-related injuries. No applicable intervention, but the main outcome measure was a description of injuries sustained due to participation in billiards. Billiards-related injury was captured by the National Electronic Injury Surveillance System - All Injury Program database. We extracted information on age, gender, injury, and disposition. A collective total of 78,524 (n = 1214) estimated patients, had emergency department visits after incurring billiards-related injuries as a sample. The mean age was 24.9 years. Most injuries occurred in males, 54,915 (n = 851, 69.9%). More injuries appeared to be soft-tissue contusions and abrasions, 19,000 (24.2%, n = 280), followed by lacerations, 17,520 (22.3%, n = 269). The most common cause of injury was being struck by a ball or cue, 39,705 (51.1%, n = 643). While the majority of injured patients were discharged home after evaluation, 2527 (3.2%, n = 45) of them required hospitalization. While a small number of billiards-related injuries presented to the emergency department in comparison to other sports-related injuries, some required more intensive treatment or hospitalization.

Traumatic Foreign Body into the Face: Case Report and Literature Review

This paper describes a case of mouth opening limitation, secondary to a facial trauma by cutting-piercing instrument, whose fragments had not been diagnosed in the immediate posttrauma care. Description of an unusual surgical maneuver and a literature review are presented.

Management of Self-Harm Injuries in the Maxillofacial Region: A Report of 2 Cases and Review of the Literature

Clinicians face numerous challenges when managing psychiatric patients who self-inflict injuries within the maxillofacial region. In addition to a complex clinical examination, there are both surgical and psychiatric factors to consider, such as the risk of damaging vital structures, the exacerbation of the patient's psychiatric status, and the long-term psychosocial and esthetic sequelae. We present 2 cases of adolescents who repeatedly self-inflicted wounds and/or inserted foreign bodies (FBs) into the face, scalp, and neck. The different treatment modalities were based on full evaluation of the patient's clinical, medical, and diagnostic test findings coupled with a psychiatric assessment. The decision for conservative management or surgical intervention was made according to the presence and location of the FBs, degree of hemorrhage, signs and symptoms of infection, and unpleasant scars that could lead to long-term psychological impairment. In most cases, the FBs were removed and the wounds were toileted and closed under local or general anesthesia. We advocate a holistic approach via a multidisciplinary team, which is deemed essential to provide the highest quality of care for patients to reduce the risk of further relapses. Lastly, a satisfactory esthetic outcome is always paramount to achieve long-term psychological and physical welfare.

Penetrating injury of face by a large machine bolt-a rare case report

Foreign bodies are often encountered by oral and maxillofacial surgeons and may present a diagnostic challenge, due to many factors such as nature of foreign body material, the size of the object, difficult access and a close anatomical relationship of the foreign body to vital structures. There are foreign bodies like glass pieces, plastic materials, wooden pieces are not seen in routine radiographs and often misdiagnosed. To reduce the chances of complications presence of foreign body in the patients head and neck region must be thoroughly investigated by the surgeon. Penetrating injuries by blunt object is rare finding in maxillofacial region. Here we present an unusual case of penetrating injury by a large machine bolt (15.0 cm) in a 7 year old child, embedded on left side of face.

An unusual case of maxillary sinus trauma

Maxillary sinus foreign bodies are commonly due to penetrating trauma and iatrogenic events. A foreign body is usually identified during initial assessment and subsequently removed. We present a rare method of maxillary sinus trauma with retained and subsequent discharged foreign body twelve years following the initial injury.

Impacted foreign bodies in the maxillofacial region-diagnosis and treatment

Foreign bodies are often encountered by oral and maxillofacial surgeons and may present a diagnostic challenge to the trauma surgeon due to many factors such as the size of the object, the difficult access, and a close anatomic relationship of the foreign body to vital structures. They are usually a result of injuries or operations. Fragments of broken instruments can be left behind and entire teeth or their fragments can be displaced during extraction. The approach to this kind of injury should be sequential and multidisciplinary, beginning with the trauma unit that will provide maintenance of the airways, hemodynamic stabilization, and, but only if necessary, neurologic, ophthalmologic, and vascular evaluation. With a view to illustrating and discussing the diagnosis and treatment of this kind of injury, this study reports impacted foreign bodies in oral and maxillofacial region. The following data were collected: age, sex, race, etiology, occurrence of fracture, anatomic location of the fracture, daytime of the traumatic event, type of the object, signal and symptoms, type of imaging examination used, type of anesthesia, approach, transoperative complication, period between surgery and hospital liberation, and the occurrence of death. Foreign body injuries in the maxillofacial region can place the patient's life at risk, so a correct initial treatment performed by a multidisciplinary team increases the survival of this kind of patient.

Remote penetrating orbital trauma due to a snooker cue through the mouth

PURPOSE

 This is a unique case report of a self-inflicted orbital injury that presented as a simple upper vestibulum laceration. A 43-year-old man presented to the Oral and Maxillofacial Surgery Unit with a small laceration in his mouth and complaints of pain in his left eye due to a snooker cue penetration. Upon admission, clinical findings included a small laceration on the upper left vestibulum and a subdermal hematoma in the left eye lid with restricted movements of the left eye. Further examination revealed remote trauma to the orbit, penetrating through the oral cavity, passing the maxillary sinus, and the orbital floor causing traumatic optic neuropathy with partial visual loss. The patient was treated conservatively with antibiotics and corticosteroids and a 6-week follow up.

CONCLUSION

 In cases of remote penetrating injury, meticulous examination revealing precise injury mechanism is crucial. All cases of Dento-maxillofacial trauma should include a high degree of clinical suspicion for ocular injury, requiring early diagnosis and treatment to reduce risk of visual loss.

Foreign body in preauricular region

Foreign bodies, although they are often found throughout the body, to a lesser degree in the face, still constitute a diagnostic challenge for the trauma surgeon. Its removal means danger of damaging important facial anatomic structures, even if its exact position from the image data was known. So, the objective is to describe a clinical report of a patient (42 years of age, male sex) who experienced falling to the ground, attended by the Department of Surgery and Traumatology Bucco-Maxillo-Facial Surgery, Faculty of Dentistry of Araçatuba, São Paulo State University, and 2 days after the trauma, he reported difficulty in mouth opening and pain. After clinical evaluation, we observed the presence of injury in the left preauricular region already in the process of healing. During the intraoral physical examination, a limitation of the mouth opening was noted. Radiographic posteroanterior and profile of the face showed 2 radiopaque foreign bodies in the left side, lying apparently at the region of the mandibular condylar process. Under local anesthesia, foreign body removal was carried from there with access to it through the preexisting facial injury. Further clinical examinations showed an improvement in mouth opening, absence of pain complaints, and/or functional complaints.

Wooden foreign body embedded in the zygomatic region for 2 years

We report a case of retained wooden foreign body in the zygomatic region which posed a considerable diagnostic difficulty and was the source of persistent draining sinus and other distressing symptoms. The patient was not aware of the foreign body in the maxillofacial region. In such cases a thorough history of the patient is of utmost importance. The case has been described to highlight the problems associated in managing unlikely foreign bodies at unusual facial sites when there is a possibility that radiolucent material is embedded in the wound.