Singh Monika, Mishra Niranjan, Baig Shadab Ali, Sahu Gyana Ranjan, Kar Indu Bhusan
Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha 753007 India.
J Maxillofac Oral Surg. 2025 Jun;24(3):636-645. doi: 10.1007/s12663-025-02485-5. Epub 2025 Feb 15.
Bear attacks constitute only 0.1% of all animal attacks in India. Odisha, one of the eastern coastal states of India, represents prime habitat for sloth bear. Jaws and claws can impart forces up to 1800 psi causing devitalization, crushing, cutting, avulsion and puncture injuries resulting in significant functional and aesthetic disfigurement making its management challenging. The aim of the study is to review 30 cases of complex maxillofacial injuries in patients with bear mauling attacks and to discuss the various challenges for management of maxillofacial defects in these patients and to provide a treatment guideline for their management.
This is a retrospective, monocentric case series study to review 30 cases of complex maxillofacial injuries in patients with bear mauling attacks, reported to a tertiary care center in Odisha between 2010 and 2023. Various covariates included were demographic characteristics, injury characteristics, treatment modalities and complications. Descriptive statistics were computed for each study variable.
The sample was composed of 30 patients with 22 males (73.34%) and 8 females (26.66%). The age of the patients ranged between 0-60 years (73.34%) and more than 60 years (26.6%). All patients reported with maxillofacial injury (100%) along with involvement of other body parts. The mortality rate in this case series was 3.34%. Management of maxillofacial defects were done with primary closure, local flaps, and vascularized free flaps.
Bear attacks can cause gross maxillofacial deformities, systemic dysfunction, risk of airway obstruction and high risk of tetanus and rabies. Management of patients with bear mauling maxillofacial injuries carries a lot of challenges and risks. Timely comprehensive management is important for providing better quality of life to the patients, restoration of function and esthetics, and a balanced psychological condition.
在印度，熊袭击仅占所有动物袭击事件的0.1%。印度东部沿海邦之一的奥里萨邦是懒熊的主要栖息地。熊的 jaws 和爪子可施加高达1800磅力/平方英寸的力量，导致组织失活、挤压、切割、撕脱和穿刺伤，造成严重的功能和美观缺陷，使其治疗具有挑战性。本研究的目的是回顾30例熊袭击患者的复杂颌面损伤病例，讨论这些患者颌面缺损管理的各种挑战，并为其管理提供治疗指南。
这是一项回顾性、单中心病例系列研究，回顾了2010年至2023年期间报告给奥里萨邦一家三级护理中心的30例熊袭击患者的复杂颌面损伤病例。纳入的各种协变量包括人口统计学特征、损伤特征、治疗方式和并发症。对每个研究变量进行描述性统计。
样本包括30例患者，其中男性22例（73.34%），女性8例（26.66%）。患者年龄在0至60岁之间（73.34%），超过60岁的占26.6%。所有患者均报告有颌面损伤（100%），同时伴有其他身体部位受伤。本病例系列的死亡率为3.34%。颌面缺损的处理采用一期缝合、局部皮瓣和带血管游离皮瓣。
熊袭击可导致严重的颌面畸形、全身功能障碍、气道梗阻风险以及破伤风和狂犬病的高风险。熊袭击导致颌面损伤患者的管理面临诸多挑战和风险。及时的综合管理对于提高患者生活质量、恢复功能和美观以及保持心理平衡至关重要。
