Self-inflicted craniofacial impalement injury with a screwdriver during the COVID-19 pandemic: A case report

ABSTRACT

Objective@#To present a case of a 37-year-old man presenting with craniofacial impalement injury from a screwdriver that happened during the early stages of the COVID-19 pandemic. @*Methods@#Design: Case Report. Setting: Tertiary Government Training Hospital. Patient One. @*Results@#During the early stages of COVID-19 pandemic a 37-year-old man was brought to the emergency room with a screwdriver embedded in his right eye. A multidisciplinary team observing available recommendations (level IV PPE, carefully planned operative directives) successfully performed endoscopic endonasal transsphenoidal surgery with application of a nasoseptal Hadad flap and abdominal fat obliteration. Aside from medial gaze limitations of the right eye, there was no CSF leak or rhinorrhea and no neurologic sequelae on follow up. @*Conclusion@#Endoscopic skull base surgery for such an impalement injury as this is a formidable multidisciplinary challenge, even in normal times. The early stages of the COVID-19 pandemic presented additional challenges. Observing evolving guidelines minimized the high risk of exposure for health care workers while maximizing care for the patient.