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Penetrating injury of the cheek requiring skull base exploration

Published online by Cambridge University Press:  08 March 2006

N. N. Patel
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, St Mary’s Hospital, London, UK.
S. C. Wang
Affiliation:
Trauma Burns Centre, University of Michigan Health System, Michigan, USA.
L. Marentette
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, University of Michigan Health System, Michigan, USA.

Abstract

We report a case of a very unusual penetrating injury of the middle third of the face. The patient was involved in a road traffic accident, and the indicator control lever became impaled in his right cheek. There was contralateral orbital damage resulting in loss of sight. The cribriform plate was breached and a pneumoencephalocele ensued.

We discuss the modern management of such injuries including injury assessment. We emphasize the importance of crash scene information gathering and analysis of injury mechanisms. Facial injury zonal classification and imaging are reviewed in the context of the case. We discuss the reasons that led us to treat this patient via the subcranial approach.

Type
Research Article
Copyright
© Royal Society of Medicine Press Limited 2002

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