Saha Shuvro, Zahan Kanij Fatema Ishrat, Subhan Kazi Irfan, Habibullah Gazi M
Neurosurgery, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Trauma Case Rep. 2025 Aug 18;59:101239. doi: 10.1016/j.tcr.2025.101239. eCollection 2025 Oct.
When a deadly non-missile object like a teta gets impacted in the maxillofacial region, the management becomes challenging. This region has a complex anatomical structure with high vascularity and contains vital structures like the orbit and airway. To avoid ophthalmic or neurological abnormalities in addition to the risk of infection and bleeding, accurate clinical and radiological diagnosis and optimal surgical techniques with postoperative management are crucial. This paper emphasizes the significance of careful preoperative planning and a concerted effort of the multidisciplinary team in managing penetrating maxillofacial injuries. A 26-year-old man was admitted under the Department of Neurosurgery at Dhaka Medical College Hospital (DMCH) with a teta impacted in his face just below the right lower eyelid, which travelled through the area of the right maxillary sinus, passing the internal carotid artery (ICA) and rested in the middle part of clivus just before basilar artery. We successfully removed the teta without any vital structure injury or visual problem. Penetrating injury in the maxillofacial region with teta due to interpersonal violence is uncommon because of the presence of protecting reflexes, and there is a dearth of documentation in the literature. The presentation, diagnosis, risk evaluation, surgical management, and outcome made this case unique.
当一个像泰塔（teta）这样的致命非导弹物体撞击颌面区域时，治疗会变得具有挑战性。该区域解剖结构复杂，血管丰富，包含眼眶和气道等重要结构。为避免除感染和出血风险外的眼科或神经学异常，准确的临床和放射学诊断以及术后管理的最佳手术技术至关重要。本文强调了术前仔细规划以及多学科团队协同努力在处理穿透性颌面损伤中的重要性。一名26岁男性因一个泰塔撞击在达卡医学院医院（DMCH）神经外科，该泰塔位于其右下眼睑下方的面部，穿过右上颌窦区域，经过颈内动脉（ICA），并在基底动脉前停留在斜坡中部。我们成功取出了泰塔，未造成任何重要结构损伤或视觉问题。由于存在保护反射，人际暴力导致的颌面区域泰塔穿透伤并不常见，且文献中缺乏相关记录。该病例的表现、诊断、风险评估、手术治疗及结果使其具有独特性。
