Diagnostic and therapeutic aspects in the treatment of gunshot wounds of the viscerocranium

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
A GröbeP Pohlenz

Abstract

Gunshot wounds of the viscerocranium are a rare occurrence during times of peace in Europe. The removal of projectiles is recommended; in some cases, however, this is controversial. The material properties of projectiles and destruction of anatomical landmarks make it difficult to determine their precise location. Therefore, navigation systems and cone-beam computed tomography (CT) provide the surgeon with continuous intraoperative orientation in real-time. The aim of this study was to report our experiences for image-guided removal of projectiles, the use of cone-beam computed tomography and the resulting intra- and postoperative complications. We investigated 50 patients with gunshot wounds of the facial skeleton retrospectively, 32 had image-guided surgical removal of projectiles in the oral and maxillofacial region, 18 had surgical removal of projectiles without navigation assistance and in 28 cases we used cone-beam CT in the case of dislocated projectiles and fractured bones. There was a significant correlation (p = 0.0136) between the navigated versus not navigated surgery and complication rate (8 vs. 32%, p = 0.0132) including major bleeding, soft tissue infections and nerve damage. Furthermore, we could reduce operatin...Continue Reading

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Citations

Jul 3, 2013·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Haijun GuiJoy S Bautista
Jan 15, 2019·The Journal of Craniofacial Surgery·Michael R DeLongReza Jarrahy
Jul 2, 2020·International Journal of Oral and Maxillofacial Surgery·S L AssoulineA Louvrier

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