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颅面部复杂型异物穿透伤及其外科治疗:三例报告

Complex-Type Foreign Body Penetrating Injuries of the Craniofacial Region and Surgical Management: A Report of Three Cases.

作者信息

Singh Virendra, Dahiya Ankita, Britto Aakash, Bhagol Amrish, Kumar Prashant, Jajodia Neha, Tanwar Rajiv

机构信息

Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, Haryana 124001 India.

Department of Anaesthesiology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana 124001 India.

出版信息

J Maxillofac Oral Surg. 2024 Aug;23(4):1033-1040. doi: 10.1007/s12663-024-02152-1. Epub 2024 Mar 27.

DOI:10.1007/s12663-024-02152-1
PMID:39118930
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11303601/
Abstract

INTRODUCTION

Craniofacial penetrating injuries are not a rare sight in the career of oral and maxillofacial surgeons and trainees, but bizarre craniomaxillofacial sharp injuries caused by peculiar foreign bodies to the head and neck region, complicating and obscuring the vital structures, are seldom found. Foreign bodies such as lunch boxes, wooden branches or twigs are peculiarly associated with penetrating/perforating craniofacial severe impaled injuries with dramatic consequences.

CASE REPORT

Three cases are reported, with elaborate descriptions of the site, kind, and severity of the injuries. Cases 1 and 3, wooden impalement injuries into the neck region and sensitive orbital region, respectively, necessitating immediate surgical retrieval as in both cases. In case 2, 4-year old sustained an injury with a sharp rim of the lunch box, obscuring the entire craniofacial region and impeding the primary care and assessment.Cases represent the peculiarity of the injuries caused by unusual foreign bodies and how their uniqueness demanded a different surgical intervention.The need for a multidisciplinary approach is crucial to managing these injuries in areas with a high degree of specialization overlap, such as the craniofacial region.

CONCLUSION

We give an overview of the diagnosis and treatment of penetrating foreign body trauma encountered in our department. Every foreign body penetrating trauma demands a formulation of a different surgical plan and stands as a challenge for the treating surgeons. Adequate radiology knowledge, detection, vigilant clinical assessment, and tension-free closure are a few of the important aspects for the ideal management of penetrating foreign body trauma.

摘要

引言

颅面部穿透伤在口腔颌面外科医生和实习生的职业生涯中并不罕见,但由特殊异物导致的头部和颈部区域离奇的颅颌面锐器伤,使重要结构变得复杂且难以辨认的情况却很少见。诸如饭盒、树枝或细枝等异物特别容易导致穿透性/穿孔性颅面部严重刺入伤,并产生严重后果。

病例报告

报告了三例病例,并详细描述了损伤的部位、类型和严重程度。病例1和病例3分别为树枝刺入颈部区域和敏感的眼眶区域,两例均需要立即进行手术取出。病例2中,一名4岁儿童被饭盒锋利的边缘划伤,整个颅面部区域受伤,妨碍了初步护理和评估。这些病例体现了由不寻常异物造成的损伤的特殊性,以及其独特性如何需要不同的手术干预。在颅面部等高度专业化重叠的区域,多学科方法对于处理这些损伤至关重要。

结论

我们概述了本部门遇到的穿透性异物创伤的诊断和治疗。每一例异物穿透伤都需要制定不同的手术方案,这对治疗外科医生来说是一项挑战。足够的放射学知识、检测、警惕的临床评估以及无张力缝合是理想处理穿透性异物创伤的几个重要方面。