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Orbito-Cranial Gunshot Injuries with Retained Sinonasal Bullets

Journal of Maxillofacial and Oral Surgery volume 20, pages 551–557 (2021)Cite this article

Abstract

Introduction

Gunshot injuries to the sino-orbital region are rare. In South Africa, where gunshot injuries are common, sino-orbital gunshot injuries are encountered. Sino-orbital gunshot injuries are associated with trauma to surrounding facial and intracranial structures. Therefore, the management of these injuries may be complex and often requires an interdisciplinary approach.

Aims

To review the management of orbito-cranial gunshot injuries with retained sinonasal bullets.

Patients and methods

Three cases of orbito-cranial gunshot injuries with retained sinonasal bullets were reviewed. Two cases were complicated by cerebrospinal fluid leaks with ensuing meningitis. The retained bullets in all three cases were successfully removed via a transnasal endoscopic approach.

Conclusion

Sino-orbital gunshot injuries are rare, but may be encountered in areas with high frequencies of gun violence. An associated anterior skull base fracture with CSF rhinorrhoea poses a risk for meningitis and a low threshold for diagnosis and treatment of meningitis should be maintained. Retained bullets in the paranasal sinuses do not pose an immediate risk and may be removed on an elective basis.

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Acknowledgments

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Authors and Affiliations

  1. Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

    Gerrit Viljoen, Nicholas Goncalves & Darlene Lubbe

  2. Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

    Sean Tromp & Patrick Semple

Authors
  1. Gerrit Viljoen
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  2. Sean Tromp
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  3. Nicholas Goncalves
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  4. Patrick Semple
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  5. Darlene Lubbe
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Correspondence to Gerrit Viljoen.

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Viljoen, G., Tromp, S., Goncalves, N. et al. Orbito-Cranial Gunshot Injuries with Retained Sinonasal Bullets. J. Maxillofac. Oral Surg. 20, 551–557 (2021). https://doi.org/10.1007/s12663-020-01365-4

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  • DOI: https://doi.org/10.1007/s12663-020-01365-4

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