Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T11:17:26.112Z Has data issue: false hasContentIssue false

Low velocity gunshot injuries to the temporal bone

Published online by Cambridge University Press:  29 June 2007

Steven L. Sabin*
Affiliation:
State University of New York – Health Science CenterBrooklyn, N.Y., U.S.A.
Dennis Lee
Affiliation:
State University of New York – Health Science CenterBrooklyn, N.Y., U.S.A.
Gady Har-El
Affiliation:
State University of New York – Health Science CenterBrooklyn, N.Y., U.S.A.
*
Address for correrspondence: Steven L. Sabin, M.D., Otolaryngology Associates of Central New Jersey, B-3 Cornwall Drive, East Brunswick, N.J. 08816, U.S.A..

Abstract

Objective

To review the presentation, symptoms and management associated with low velocity gunshot injuries to the temporal bone.

Methods

A retrospective analysis of 26 patients treated for low velocity gunshot injuries to the temporal bone.

Results

Initial presentation included otorrhoea (69 per cent), facial nerve injury (27 per cent), hearing loss (65 per cent), intracranial injuries (50 per cent), and cranial neuropathies (58 per cent). Nine patients (35 per cent) underwent angiography, which showed vascular injury in five of them. Four patients died.

Conclusion

Low velocity gunshot injuries can be devastating and may result in functional sequelae. Low velocity missiles crush and lacerate surrounding structures, while high velocity missiles cause extensive wound cavity formation. Early aggressive management for intracranial, vascular and facial nerve injury can improve outcome.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Annual Meeting of the American Academy of Otolaryngology – Head and Neck Surgery, Washington, D.C., September 1996.

References

CDC (1994) Deaths resulting from firearm and motor-vehicle-related injuries – United States, 1968–1991. Journal of the American Medical Association 271: 495496.CrossRefGoogle Scholar
Dahigram, B., Berlin, R., Janzon, B. (1979) The extent of muscle tissue damage following missile trauma one, six and 12 hours after the infliction of trauma. Studied by current method of debridement. Acta Chirurgica Scandinavica (Suppl) 489: 137144.Google Scholar
Duncan, N. O., Coker, N. J., Jenkins, H. A., Canalis, R. F. (1986) Gunshot injuries of the temporal bone. Otolaryngology – Head and Neck Surgery 94: 4755.CrossRefGoogle ScholarPubMed
Fingerhot, L. A., Kleinman, J. C., Godfrey, E., Rosenberg, H. (1991) Firearm mortality among children, youths and young adults 1–34 years of age, trends and current status: United States 1979–1988. Monthly Vital Statistics Report 39: 116.Google Scholar
Goodwin, W. J. (1983) Temporal bone fractures. Otolaryngologic Clinics of North America 16: 651670.CrossRefGoogle ScholarPubMed
Gros, J. C. (1967) The ear in skull trauma. Southern Medical Journal 60: 705711.CrossRefGoogle ScholarPubMed
Haberkamp, T. J., McFadden, E., Khafagy, Y., Harvey, S. A. (1995) Gunshot injuries of the temporal bone. Laryngoscope 105: 10531057.CrossRefGoogle ScholarPubMed
Hagan, W. E., Tabb, H. G., Cox, R. H., Travis, L. W. (1979) Gunshot injury to the temporal bone: An analysis of thirty five cases. Laryngoscope 89: 12581272.CrossRefGoogle Scholar
Hooper, R. E., Ruben, R. J., Mahmood, K. (1972) Gunshot injuries of the temporal bone. Archives of Otolaryngology 96: 433440.CrossRefGoogle ScholarPubMed
Kaufman, H. H. (1993) Civilian gunshot wounds to the head. Neurosurgery 32: 962964.CrossRefGoogle ScholarPubMed
Levy, M. L., Masri, L. S., Levy, K. M. (1993) Penetrating cramocerebral injury resultant from gunshot wounds: Gang related injury in children and adolescents. Neurosurgery 33: 10181024.Google ScholarPubMed
Ramenofsky, M. L., All, J., Aprahamian, C. (1989) Advanced trauma life support course. Chicago III: The American College of Surgeons.Google Scholar
Scalfani, A. P., Scalfani, S. J. (1996) Angiography and transcatheter arterial embolization of vascular injuries of the face and neck. Laryngoscope 106: 168173.CrossRefGoogle Scholar
Scalfani, S. J., Cavalierre, G., Atweh, N., Duncan, A., Scalea, T. (1991) The role of angiography in penetrating neck trauma. Journal of Trauma 31: 557563.CrossRefGoogle Scholar
Shindo, M. L., Fetterman, B. L., Shin, L., Maceri, D. R., Rice, D. H. (1995) Gunshot wounds to the temporal bone: A rational approach to evaluation and management. Otolaryngology – Head and Neck Surgery 112: 533539.Google Scholar
Stiernberg, C. M., Jahrsdoeter, R. A., Gillenwater, A., Jue, S. A., Alcalen, S. V. (1992) Gunshot wounds to the head and neck. Archives of Otolaryngology – Head and Neck Surgery 118: 592597.CrossRefGoogle Scholar
Stone, S. L., Lichtor, T., Fitzgerald, L. F., Barrett, J. A., Reyes, H. M. (1995) Demographics of civilian cranial gunshot wounds: Devastation related to escalating semi-automatic usage. Journal of Trauma 38: 851854.CrossRefGoogle Scholar
Tian, H., Guanggui, D., Huang, M. (1988) Quantitative bacteriological study of the wound track. Journal of Trauma (Suppl 28) 1: 215227.CrossRefGoogle Scholar
Tainmont, J. (1983) Traumatic and high velocity missile wounds. Acta Oto-Rhino-Laryngologica Belgica 37: 419429.Google ScholarPubMed
Thorsby, F. P., Darlow, H. M. (1967) The mechanism of primary infections of bullet wounds. British Journal of Surgery 54: 359361.CrossRefGoogle Scholar