Orbito-Cranial Gunshot Injuries with Retained Sinonasal Bullets

Introduction Gunshot injuries to the sino-orbital region are rare. In South Africa, where gunshot injuries are common, sino-orbital gunshot injuries are encountered. Sino-orbital gunshot injuries are associated with trauma to surrounding facial and intracranial structures. Therefore, the management...

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Bibliographic Details
Published in:Journal of maxillofacial and oral surgery 2021-12, Vol.20 (4), p.551-557
Main Authors: Viljoen, Gerrit, Tromp, Sean, Goncalves, Nicholas, Semple, Patrick, Lubbe, Darlene
Format: Article
Language:English
Subjects:
Cerebrospinal fluid
Clinical Paper
Cysts
Dentistry
Endoscopy
Epistaxis
Firearms
Fistula
Foreign bodies
Injuries
Lead content
Lead poisoning
Magnetic resonance imaging
Medical imaging
Medicine
Medicine & Public Health
Oral and Maxillofacial Surgery
Otolaryngology
Otorhinolaryngology
Patients
Plastic Surgery
Shootings
Sinuses
Tomography
Trauma
Velocity
Visual acuity
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Summary:Introduction Gunshot injuries to the sino-orbital region are rare. In South Africa, where gunshot injuries are common, sino-orbital gunshot injuries are encountered. Sino-orbital gunshot injuries are associated with trauma to surrounding facial and intracranial structures. Therefore, the management of these injuries may be complex and often requires an interdisciplinary approach. Aims To review the management of orbito-cranial gunshot injuries with retained sinonasal bullets. Patients and methods Three cases of orbito-cranial gunshot injuries with retained sinonasal bullets were reviewed. Two cases were complicated by cerebrospinal fluid leaks with ensuing meningitis. The retained bullets in all three cases were successfully removed via a transnasal endoscopic approach. Conclusion Sino-orbital gunshot injuries are rare, but may be encountered in areas with high frequencies of gun violence. An associated anterior skull base fracture with CSF rhinorrhoea poses a risk for meningitis and a low threshold for diagnosis and treatment of meningitis should be maintained. Retained bullets in the paranasal sinuses do not pose an immediate risk and may be removed on an elective basis.
ISSN:0972-8279
0974-942X
DOI:10.1007/s12663-020-01365-4