Resumen
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.
Citas
Firat C., Geyik Y. Surgical modalities in gunshot wounds of the face. J Craniofac Surg [Internet]. 2013;24(4):1322-6. Available from:http://www.ncbi.nlm.nih.gov/pubmed/23851799
Shackford S. R., Kahl J. E., Calvo R. Y., Kozar R. A., Haugen C. E., Kaups K. L., et al. Gunshot wounds and blast injuries to the face are associated with significant morbidity and mortality. J Trauma Acute Care Surg [Internet]. 2014;76(2):347-52. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=01586154-201402000-00013
Tholpady S. S., Demoss P., Murage K. P., Havlik R. J., Flores R. L. Epidemiology, demographics, and outcomes of craniomaxillofacial gunshot wounds in a Level i trauma center. J Cranio-Maxillofacial Surg [Internet]. 2014; 42 (5): 403-11. Available from: http://dx.doi.org/10.1016/j.jcms.2013.06.004
Allareddy V., Nalliah R., Lee M. K., Rampa S., Allareddy V. Impact of Facial Fractures and Intracranial Injuries on Hospitalization Outcomes Following Firearm Injuries. JAMA Otolaryngol Neck Surg [Internet]. 2014;140 (4): 303. Available from: http://archotol.jamanetwork.com/article.aspx?doi=10.1001/jamaoto.2014.61
Hernández-Téllez I. E., Palmieri-Bouchan R. B., García-Valadez L. R., Ibáñez-Guerrero O., Castellanos-Velazco C.A. Epidemiología de las heridas por proyectil de arma de fuego en el Hospital Central Militar de México. Gunshot wounds Epidemiol Mex Mil Cent Hosp [Internet]. 2015; 69 (3): 204-17. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=108669027&lang=es&site=ehost-live
Moye-Elizalde G. A., Ruiz-Martínez F., Suarez-Santamaría J. J., Ruiz-Ramírez M., Reyes-Gallardo A. D-AB. Epidemiología de las lesiones por proyectil de arma de fuego en el Hospital General de Ciudad Juárez, Chihuahua. 2013; 27 (4): 221-35.
Yamsani B., Gaddipati R., Vura N., Ramisetti S., Yamsani R. Zygomaticomaxillary Complex Fractures: A Review of 101 Cases. J Maxillofac Oral Surg [Internet]. 2016; 15 (4): 417-24. Available from: http://link.springer.com/10.1007/s12663-015-0851-9
Miloro M., Peter G. E. G., Peter E.L. Peterson’s Rinciples of Oral and Maxillofacial [Internet]. City. 2004. 1502 p. Available from: www.allislam.net-Problem
Norton R. KO. Injuries. N Engl J Med. 2013; 3 (68): 1723–9.
Naranjo R., Duque F. AE. Experiencia en el diagnóstico y tratamiento del paciente con trauma maxilofacial por arma de fuego en el servicio de cirugía maxilofacial del hospital universitario de San Vicente Paúl de Medellin entre 1998 y 2003. 2005; 16:33-41.
Hollier L., Grantcharova E. P., Kattash M. Facial gunshot wounds: A 4-year experience. J Oral Maxillofac Surg. 2001; 59 (3): 277-82.
Maurin O., de Régloix S., Dubourdieu S., Lefort H., Boizat S., Houze B., et al. Maxillofacial Gunshot Wounds. Prehosp Disaster Med [Internet]. 2015; 30 (3): 316-9. Available from: http://www.journals.cambridge.org/abstract_S1049023X1500463X
Norris O., Mehra P., Salama A. Maxillofacial Gunshot Injuries at an Urban Level I Trauma Center - 10-Year Analysis. J Oral Maxillofac Surg [Internet]. 2015; 73 (8): 1532-9. Available from: http://dx.doi.org/10.1016/j.joms.2015.03.019
Gray S. T. Epidemiological Survey of Head and Neck Injuries and Trauma in the United States. Otolaryngol Head Neck Surg. 2015; 151 (5): 776-84.
José H., González E., Cavazos J. C., Palacios-zertuche J., Reyna-sepúlveda F. Epidemiology of gunshot wounds in the University Autonomous University of Nuevo León. Cir Cir. 2017; 85 (1).
Gotsch K. E., Annest J. L., Mercy J. A. RG. Surveillance for fatal and nonfatal firearm-related injuries-United States 1993-1998. MMWR Morb Mortal Wky Rep. 2001;50.
Pollock R. A. Craniomaxillofacial Buttresses - Anatomy and Operative Repair. Head Neck [Internet]. 2012; 35 (11): 1. Available from: http://books.google.ca/books?id=RiM70odQU8EC%5Cnhttp://doi.wiley.com/10.1002/hed.23416
Kalantar Motamedi M. H. Comprehensive Management of Maxillofacial Projectile Injuries at the First Operation; “picking up the Pieces.” Trauma Mon. 2012; 17 (4): 365-6.
Motamedi M. H. Management of firearm injuries to the facial skeleton: Outcomes from early primary intervention. J Emerg Trauma Shock [Internet]. 2011;4 (2): 212. Available from: http://www.onlinejets.org/text.asp?2011/4/2/212/82208
Chia H. N., Wu B. M. Recent advances in 3D printing of biomaterials. J Biol Eng [Internet]. 2015; 9 (1): 4. Available from: http://www.jbioleng.org/content/9/1/4
Dawood A., Marti B. M., Sauret-Jackson V., Darwood A. 3D printing in dentistry. Bdj [Internet]. 2015; 219 (11): 521-9. Available from: http://www.nature.com/doifinder/10.1038/sj.bdj.2015.914
Kreuzer P. M., Landgrebe M., Vielsmeier V., Kleinjung T., De Ridder D., Langguth B. Trauma-Associated Tinnitus. J Head Trauma Rehabil [Internet]. 2014; 29 (5): 432-42. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00001199-201409000-00006
Wysocki J. Cadaveric dissections based on observations of injuries to the temporal bone structures following head trauma. Skull Base. 2005; 15 (2): 99-106.
Mellema P. A., Dewan M. A., Lee M. S., Smith S. D., Harrison A. R. Incidence of Ocular Injury in Visually Asymptomatic Orbital Fractures. Ophthalmic Plast Reconstr Surg [Internet]. 2009; 25 (4): 306–8. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00002341-200907000-00013