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Surgical Management of a Firearm Injury in the Infraorbital Area / Manejo quirúrgico de una herida por arma de fuego en el área infraorbitaria
Medina A, Heriberto; Sansores E, Daniel; González K, Debora; Arriola P, Fabio.
  • Medina A, Heriberto; Agustin O´Horan. Department of Dentistry and Oral Maxillofacial Surgery. MX
  • Sansores E, Daniel; Department of Dentistry and Oral Maxillofacial Surgery. MX
  • González K, Debora; Agustin O´Horan. Department of Dentistry and Oral Maxillofacial Surgery. MX
  • Arriola P, Fabio; Department of Dentistry and Oral Maxillofacial Surgery. MX
Odovtos (En línea) ; 20(1): 33-39, Jan.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-1091435
ABSTRACT
Abstract The surgical management of firearm injuries to the zygomaticomaxillary complex is a topic that needs to be addressed with much care. The complications that can arise during treatment, as well as the potential residual problems that can appear, lead to the need of recognizing these injuries as a maxillofacial treatment challenge. The infraorbital zone is the second most common area of injury in the face, accounting for up to 45% of midfacial fractures. The case presented is of a 54 year old man affected by the backward firing of a gun rifle that caused an oblique impaction towards the posterior lateral inferior side of the infraorbital complex. He was rapidly stabilized with an antibiotic and analgesic scheme, yet presented the following a comminute fracture of the orbit floor with consequent communication towards the maxillary sinus, a non-displacing fracture of the frontomalar suture, a non-displacing fracture of the zygomatic arch and a lesion with loss of osseous tissue in the petrous region of the temporal bone. Rigid fixation followed stabilization, and the area was covered with a titanium mesh. Occasional tinnitus and photopsia were reported by the patient upon return, yet all other evaluated factors were in order. There have been different forms of management described in the literature, and it is recognized that each patient has different needs, therefore each case must be closely evaluated, so it is approached in the most appropriate manner.
RESUMEN
Resumen El manejo quirúrgico de las lesiones por armas de fuego al complejo cigomaticomaxilar representa una situación compleja en la práctica maxilofacial que debe ser abordada con extrema cautela, debido a las complicaciones que pueden surgir durante el tratamiento y los potenciales problemas residuales. La zona infraorbitaria es la segunda área más común de lesiones en la cara, representando hasta 45% de las fracturas mediocraneales. El presente caso es de un masculino de 54 años de edad, que sufrió trauma ocasionado por la parte trasera de un rifle de caza que causó un impacto en sentido oblicuo hacia el lado lateral inferior del complejo infraorbitario. El paciente fue estabilizado con esquema antibiótico y analgésico, el diagnóstico fue fractura cominuta del piso de la órbita, con consecuente comunicación al seno maxilar, fractura no desplazada de la sutura frontomalar, fractura no desplazada del arco cigomático, y lesión con pérdida de tejido óseo en la región petrosa del hueso temporal. El tratamiento quirúrgico consistió en reducción de las fracturas y fijación rígida de las estructuras. Al control post operatorio el paciente refirió acufenos y fotopsia ocasional, no presentando otras alteraciones. Se ha descrito en la literatura diferentes abordajes para el manejo de estos traumatismos, sin embargo cada caso debe ser individualizado y evaluado de forma minuciosa para que éste, sea el adecuado.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Skull Fractures / Wounds, Gunshot / Zygoma / Mandibular Fractures Limits: Humans / Male Language: English Journal: Odovtos (En línea) Journal subject: Cirurgia Geral / Oftalmologia / Ortopedia Year: 2018 Type: Article Affiliation country: Mexico Institution/Affiliation country: Agustin O´Horan/MX / Department of Dentistry and Oral Maxillofacial Surgery/MX

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Full text: Available Index: LILACS (Americas) Main subject: Skull Fractures / Wounds, Gunshot / Zygoma / Mandibular Fractures Limits: Humans / Male Language: English Journal: Odovtos (En línea) Journal subject: Cirurgia Geral / Oftalmologia / Ortopedia Year: 2018 Type: Article Affiliation country: Mexico Institution/Affiliation country: Agustin O´Horan/MX / Department of Dentistry and Oral Maxillofacial Surgery/MX