Management of Facial Penetrating Injury—A Case Report

Tabariai, Eli; Sandhu, Shabaz; Alexander, Gerald; Townsend, Ricard N.; Julian, Robert; Bell, Greg; Chien, A. T.; Soares, Beau; Sikavi, Cameron

doi:10.1016/j.joms.2009.09.008

Cited by 10 publications

(12 citation statements)

References 22 publications

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“…It is noteworthy that continued blood loss could still occur due to the presence of rich arterial collaterals or venous tributaries. 9,15…”

Section: Discussionmentioning

confidence: 99%

“…Due to the presence of vital structures in the maxillofacial region, penetrating trauma can result in neurological, ophthalmic, vascular, oropharyngeal, and skeletal complications. 8,9 Prompt implementation of Advanced Trauma Life Support (ATLS) protocol, stabilization of the patient, appropriate imaging, and early intervention can significantly reduce morbidity and mortality. 6,8,10…”

Section: Introductionmentioning

confidence: 99%

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Management of Penetrating Maxillofacial Trauma as a Result of Industrial Accident: Report of an Unusual Case

Payami

Montazem

2020

Craniomaxillofacial Trauma & Reconstruction Open

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Facial injury as a result of an industrial accident from a stationary saw is rather uncommon; however, such an injury can result in significant damage to vital structures in the maxillofacial region and can even be life-threatening. Expeditious and prompt treatment at the time of such penetrating facial injury results in a favorable outcome. Appropriate care and proper treatment of a patient with penetrating facial injury includes immediate clinical assessment, diagnostic imaging, early wound exploration, removal of the foreign body, wound debridement, repair of hard and soft tissue, and adjunctive antimicrobial therapy.

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“…It is noteworthy that continued blood loss could still occur due to the presence of rich arterial collaterals or venous tributaries. 9,15…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Penetrating Maxillofacial Trauma as a Result of Industrial Accident: Report of an Unusual Case

Payami

Montazem

2020

Craniomaxillofacial Trauma & Reconstruction Open

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“…The former, involving the left tongue root and right palatine tonsil, was similar to impalement injuries by other semi-sharp objects, such as a tree branch [11], pieces of metal [12], and wire [13]. Repeated ETI attempts may cause complete airway obstruction, with a devastating outcome.…”

Section: Discussionmentioning

confidence: 99%

“Cannot ventilate, cannot intubate” situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report

et al. 2017

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BackgroundSurfing is an increasingly popular activity and surfing-related injuries have increased accordingly. However, to the best of our knowledge, there are no reports of penetrating upper airway injuries in surfers. We present a “cannot ventilate, cannot intubate” situation following penetrating neck injury by a surfboard fin.Case presentationA previously healthy 29-year-old Japanese man was swept off his board by a large wave and his left mandible, tongue root, and right epipharynx were penetrated by the surfboard fin. He presented with severe hypovolemic shock because of copious bleeding from his mouth. Direct laryngoscopy failed, as did manual ventilation, because of the exacerbated upper airway bleeding and distorted upper airway anatomy. Open cricothyrotomy was immediately performed, followed by surgical exploration, which revealed extensive ablation of his tongue root and laceration of his lingual artery. After definitive hemostasis and intensive care, he returned home with no sequelae.ConclusionsThe long, semi-sharp surfboard fin created both extensive crushing upper airway lesions and a sharp vascular injury, resulting in a difficult airway. This case illustrates that surfing injuries can prompt a life-threatening airway emergency and serves as a caution for both surfers and health care professionals.

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“…According to Tabariary et al, factors to consider when treating a penetrating facial injury include: location and extent of the object, type of FB, vital structures in its proximity, possible sequelae of removing the FB, general extent of the injury to the hard and soft tissues, and the patient's general medical condition. 14 Apart from the location of a FB, a penetrating injury to the face can also damage deeper anatomical structures such as the facial nerve, the salivary glands and greater and lesser arteries and veins. Therefore, mandatory neck exploration is advocated for patients with penetrating neck trauma by certain surgeons because of the risk of damage to significant anatomical structures.…”

Section: Discussionmentioning

confidence: 99%

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

Malaga

Aguilera

Eaton

et al. 2016

Journal of Oral and Maxillofacial Surgery

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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.

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Management of Facial Penetrating Injury—A Case Report

Cited by 10 publications

References 22 publications

Management of Penetrating Maxillofacial Trauma as a Result of Industrial Accident: Report of an Unusual Case

Management of Penetrating Maxillofacial Trauma as a Result of Industrial Accident: Report of an Unusual Case

“Cannot ventilate, cannot intubate” situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report

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

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