Removal of a firearm projectile lodged in the infraorbital floor with preservation of the eyeball: case report

Authors

  • João Vitor Pereira Discente de Odontologia, Universidade Estadual de Londrina -UEL, Londrina, PR, Brasil. https://orcid.org/0000-0001-5937-0995
  • Karoline Von Ahn Pinto Residente em Cirurgia e Traumatologia Bucomaxilofacial, Universidade Estadual de Londrina - UEL https://orcid.org/0000-0003-3808-6017
  • Laís Albuquerque Fernandes Residente em Cirurgia e Traumatologia Bucomaxilofacial, Universidade Estadual de Londrina - UEL https://orcid.org/0000-0002-4729-7185
  • Gabriel Conceição Brito Residente em Cirurgia e Traumatologia Bucomaxilofacial, Universidade Estadual de Londrina - UEL https://orcid.org/0000-0001-7745-4594
  • Ligia Pozzobon Martins Docente do departamento de Medicina Oral, Universidade Estadual de Londrina, Preceptor do Serviço de pós-graduação em Cirurgia e Traumatologia Bucomaxilofacial, Hospital Universitário Regional Norte do Paraná– HU/UEL, Londrina, PR, Brasil https://orcid.org/0009-0009-1038-1920
  • Cecília Luiz Pereira Stabile Docente do departamento de Medicina Oral, Universidade Estadual de Londrina, Preceptor do Serviço de pós-graduação em Cirurgia e Traumatologia Bucomaxilofacial, Hospital Universitário Regional Norte do Paraná– HU/UEL, Londrina, PR, Brasil. https://orcid.org/0000-0003-1188-2769
  • Glaykon Alex Vitti Stabile Docente do departamento de Medicina Oral, Universidade Estadual de Londrina, Preceptor do Serviço de pós-graduação em Cirurgia e Traumatologia Bucomaxilofacial, Hospital Universitário Regional Norte do Paraná– HU/UEL, Londrina, PR, Brasil. https://orcid.org/0000-0001-5878-9575

DOI:

https://doi.org/10.5335/rfo.v27i1.14872

Keywords:

Gunshot wounds, Aggression, Diplopia, Facial injuries

Abstract

Aim: to report a case of gunshot wound, with ballistic projectile lodged in the left infraorbital region, reporting emergency surgical treatment for projectile exeresis by subciliary access. Case Report: An 18-year-old male patient was referred to the emergency department of the University Hospital due to a gunshot wound. On clinical examination, it was found slight increase in volume in the cervical region and left hemiface, absence of bleeding in the face; presence of limitation to infraversion of the left eye. The entrance hole of the projectile was identified in the posterior left upper thorax region; after a tomography of the face, a fracture of the left orbital floor was confirmed, as well as the projectile lodged below the eyeball. The surgery was urgently performed by the Oral and Maxillofacial Surgery team. Discussion: Studies describe the importance of performing the proper management of traumatic injuries resulting from FAF followed by removal of the projectile with urgency, since the complications to postpone the surgical time only aggravate the clinical picture of the patient, in addition to future problems that may arise with the resolution of the clinical case. Conclusion: the importance of multidisciplinarity among medical clinics is ratified, as well as the correct management of the traumatized patient, based on the criteria that lead to the treatment plan.

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References

1. Fonseca, R. J., Walker, R. J., Barber, H. D., Powers, M. P., & Frost, D. E. Trauma bucomaxilofacial. 4 ed. Elsevier Brasil (2015).

2. Chopra, N., Gervasio, K., Kalosza, B. et al. Gun trauma and ophthalmic outcomes. Eye 32, 687–692 (2018). https://doi.org/10.1038/eye.2017.249.

3. Robles LA. Orbito-cranial gunshot injury: the case of the missing entrance wound. Br J Neurosurg 2022;36:105–7. https://doi.org/10.1080/02688697.2018.1485878.

4. Kuhnen RB, Cabral RJB. Fraturas de orbita: sinais e sintomas baseados nas estruturas anatômicas envolvidas. International Journal of Dentistry (2006). https://periodicos.ufpe.br/revistas/dentistry/article/view/13859/16706.

5. Henrique P, Sales H, Henrique P, Carvalho R, Abreu DF, Sílvia A. Remoção de corpo estranho na região óculo-orbitária. Rev. Cir. Traumatol. Buco-Maxilo-Fac.2020;20:27-29. https://www.revistacirurgiabmf.com/2020/01/Arquivos/6ArtigoClinicoRemocaodecorpoestranhonaregiao.pdf.

6. Falcão MFL, Leite Segundo AV, Silveira MMF da. Estudo epidemiológico de 1758 fraturas faciais tratadas no Hospital da Restauração, Recife/PE. Rev cir traumatol buco-maxilo-fac. 2005:65-72. https://www.revistacirurgiabmf.com/2005/v5n3/pdf%20v5n3/v5n3.8.pdf.

7. Zamboni RA, Wagner JCB, Volkweis MR, Gerhardt EL, Buchmann EM, Bavaresco CS. Epidemiological study of facial fractures at the Oral and Maxillofacial Surgery Service, Santa Casa de Misericordia Hospital Complex, Porto Alegre - RS - Brazil. Rev Col Bras Cir. 2017 Sep;44. https://doi.org/10.1590/0100-69912017005011.

8. Porto DE, Costa RD, Porto É. Perfil epidemiológico dos pacientes com lesões buco-maxilo-faciais: contribuições para a eficiência dos processos de gestão hospitalar. Rev cir traumatol buco-maxilo-fac 2018:16–24. http://www.revistacirurgiabmf.com/2018/02/Artigos/03ArtOriginalPerfilepidemiologico.pdf.

9. Teixeira AL de S, Fonseca KC. Levantamento epidemiológico dos atendimentos de cirurgia e traumatologia buco-maxilo-faciais no Hospital Macrorregional de Presidente Dutra - MA. Rev cir traumatol buco-maxilo-fac 2021:6–14. http://fi-admin.bvsalud.org/document/view/pubb9.

10. Manolidis S, Weeks BH, Kirby M, Scarlett M, Hollier L. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg. 2002 Nov;13(6):726-37. https://journals.lww.com/jcraniofacialsurgery/Abstract/2002/11000/Classification_and_Surgical_Management_of_Orbital.2.aspx.

11. Scolari N, Heitz C. Protocolo de tratamento em fraturas orbitárias. Rev Fac Odontol - UPF 2012;17:365-9. http://files.bvs.br/upload/S/1413-4012/2012/v17n3/a3725.pdf.

12. Suassuna, T. M., Silva Júnior, A. J. da, Lima, E. P. de A., Landim, F. de S., & Valente, R. H. de O. Retenção de projéteis de arma de fogo na face: relato de casos. Rev. cir. traumatol. buco-maxilo-fac. 2017:46–50. https://www.revistacirurgiabmf.com/2017/01/Artigos/09ArtigocasoclinicoRetencaodeProjeteis.pdf.
13. Bansal S, Gupta B, Sharma RK, Gupta AK. Unusual foreign body in maxillary sinus causing traumatic optic neuropathy: A case report. J Oral Maxillofac Surg Med Pathol 2015;27:682–5. https://doi.org/10.1016/j.ajoms.2014.11.014.

14. Xing L, Duan Y, Zhu F, Shen M, Jia T, Liu L, et al. Computed tomography navigation combined with endoscope guidance for the removal of projectiles in the maxillofacial area: a study of 24 patients. Int J Oral Maxillofac Surg 2015;44:322–8. https://doi.org/10.1016/j.ijom.2014.12.018.

15. Burnstine MA. Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis. Ophthalmology 2002;109:1207–10; discussion 1210-1; quiz 1212–3. https://doi.org/10.1016/s0161-6420(02)01057-6.

16. Cannoni LF, Haddad L, Esteves Veiga JC. Lesões traumáticas do nervo óptico. Arq Bras Neurocir 2014;33:63–72. https://doi.org/10.1055/s-0038-1626202.

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Published

2023-11-06

Issue

Vol. 27 No. 1 (2022): RFO

Section

Caso Clínico

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This work is licensed under aCreative Commons Atribuição-NãoComercial-SemDerivações 4.0 Internacional.

How to Cite

Removal of a firearm projectile lodged in the infraorbital floor with preservation of the eyeball: case report. (2023). Revista Da Faculdade De Odontologia - UPF, 27(1). https://doi.org/10.5335/rfo.v27i1.14872