Incidence Pattern of Bear-Inflicted Injuries to the Maxillofacial Region—Soft and Hard Tissue Injuries, Their Management, and Sequelae

Ghezta, Narotam Kumar; Bhardwaj, Yogesh; Ram, Rangila; Ahsan, Razi; Arya, Saurabh

doi:10.1016/j.joms.2018.12.029

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…8 They are even known for unprovoked attacks. 9 In the present series, 25% of the attacks were unprovoked. Their attacks on humans are responsible for 67% of all animal attacks, with death to injury ratio of 1:14.3.…”

Section: Discussionsupporting

confidence: 41%

Management Challenges and Outcomes of Traumatic Brain Injury due to Bear Maul in Tribal Areas of Chhattisgarh, India—Man versus Wild

Borde

Kumar

Sahana

et al. 2021

JNRP

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Objectives Neurosurgeons working in the vicinity of tribal areas face traumatic brain injury (TBI) cases due to bear maul which is on the rise in Chhattisgarh. Most of the literature is focused on the management of maxillofacial injuries. This study intends to describe the challenges in management and outcomes of TBI due to bear maul. Materials and Methods A retrospective review was conducted from May 2018 to April 2020. The patients without TBI were excluded. The variables studied were age, gender, timing and mode of conflict, Glasgow coma scale (GCS) at arrival, injury spectrum, hospital stay, the modified Rankin score (MRS), mini mental status examination (MMSE), and surgical site infections (SSI). Results Twenty-eight patients were eligible for analysis. The mean age of presentation was 40.67 ± 13.99 years. There were 23 males (82.15%). Most common time of attack was during dawn (n = 11, 39.28%) followed by dusk (n = 9, 32.14%) and day (n = 8, 28.57%) time. Provoked conflicts were seen in 64.28%. The mean preoperative GCS was 11.07 ± 3.54 and hospital stay was 18.71 ± 9.51 days. Skull fractures were found in 24/28 (85.71%). The mean MRS was 1.67 ± 1.38 at a mean follow-up of 14.53 ± 6.59 months. Favorable outcome (MRS ≤ 2) was seen in 64.28% of patients. The mean MMSE score was 22.28 ± 5.36. Eight patients developed SSI (28.57%). Conclusion Outcomes of TBI due to bear maul depend on preoperative GCS. There are higher incidences of skull fractures and SSI. Humans need to avoid infiltration in wildlife territory to reduce the number of conflicts.

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Section: Discussionsupporting

confidence: 41%

Management Challenges and Outcomes of Traumatic Brain Injury due to Bear Maul in Tribal Areas of Chhattisgarh, India—Man versus Wild

Borde

Kumar

Sahana

et al. 2021

JNRP

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“…19 Maxillofacial and scalp injuries are common, as seen in this case, and include damage to the ears, nose, mandible, and eyes. 14 -16,19 -26 Injuries to the face and jaw occurred in 81% of cases and injuries to the scalp in 55% of cases in 1 retrospective review. 3 Complex surgical repairs, including reconstruction with skin flaps or skin grafts, are required in 25% of patients presenting with craniofacial injuries.…”

Section: Discussionmentioning

confidence: 99%

Polytrauma from a North American Black Bear Attack

Cassone

Vollmer

Factor

et al. 2020

Wilderness & Environmental Medicine

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Bear attacks, although rare, can inflict life-threatening injuries. We present the case of a 50-y-old woman from rural Pennsylvania who was attacked by a North American black bear, Ursus americanus. She sustained multiple complex injuries including near-complete scalp avulsion, bilateral ear avulsions, and fractures of the face, ribs, and pelvis. These injuries are similar to those sustained in other bear maulings reported in the literature and required both acute intervention and a multidisciplinary approach to recovery.

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“…Because of a bear attack, a person will receive multiple injuries, necessarily including the head [ 10 , 11 , 17 , 18 , 19 , 20 , 21 ]. The cranio-maxillofacial region is the most common and vulnerable site affected during a bear attack [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, according to Ghezta N.K. et al (2019), fractures of midface bones account for 71% and mandible bones account for 24% of all facial skull fractures [ 20 ]. It is possible that bears injure the faces of their victims because of the odor emanating from exposed body parts and the greater temperature of oral tissues than in the other, less-vascularized external body parts.…”

Section: Discussionmentioning

confidence: 99%

Polytrauma Caused by a Bear Attacking a Human with a Benign Outcome

Mellin,

Velichko,

Maltseva

et al. 2024

Healthcare

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Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. Such injuries are frequent in Siberia, which is a territory surrounded by dense forests inhabited by brown bears. In the last 4 months alone (September–December 2023), four bear attacks on humans were registered in Khakassia, Russia. This article presents a clinical case of rehabilitating a patient after a bear attack, who suffered multiple fragmentary fractures of the facial skeleton with displaced bone fragments, subcutaneous emphysema of the soft tissues of the face, damage to the parietal and right occipital regions and paranasal sinus hemorrhage on the left side. The nature of the injuries was enhanced by trauma to the upper extremity caused by the patient defending himself against the animal. In addition to the damage to his face, the bear tried to open his cranium, as evidenced by four furrows caused by its canines, including two each on the frontal and occipital bones of the skull. The patient’s complex treatment included both maxillofacial and reconstructive surgeries, and outpatient treatment involved the formation of normotrophic scars using a neodymium laser and injections of a heterogeneous composition consisting of microparticles of “crosslinked” collagen of animal origin placed in a gel identical to the natural extracellular matrix.

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Incidence Pattern of Bear-Inflicted Injuries to the Maxillofacial Region—Soft and Hard Tissue Injuries, Their Management, and Sequelae

Cited by 8 publications

References 23 publications

Management Challenges and Outcomes of Traumatic Brain Injury due to Bear Maul in Tribal Areas of Chhattisgarh, India—Man versus Wild

Management Challenges and Outcomes of Traumatic Brain Injury due to Bear Maul in Tribal Areas of Chhattisgarh, India—Man versus Wild

Polytrauma from a North American Black Bear Attack

Polytrauma Caused by a Bear Attacking a Human with a Benign Outcome

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