[Severe injury within the splanchnocranium and neck with penetration of foreign bodies in wood processing]

The aim of this work was to describe the patient with severe injury within the splanchnocranium and neck connected with the penetration of large foreign bodies in his wood processing activity, and their impaction in soft tissues and life-threatening localisation.

The authors describe the case of a 37-year-old male patient whose splanchnocranium and neck were injured while he was processing the wood with a mechanical saw. Two enormous wooden strips staved in his face while one was boring towards the nose and paranasal sinuses and the other was penetrating through the soft tissues of the cheek and neck from side of the oral cavity, with a visible prominent ending at the nape.

On diagnostic tests, the patient underwent tracheotomy media under neuroleptoanalgesia and infiltration anaesthesia, then, under intratracheal anaesthesia, he was intubated through tracheostomy. The two foreign bodies (enormous wooden strips) were removed by a multispecialty team of surgeons. Further, repositioning and osteosynthesis of the fractured ramus of the mandible on the left side were performed. The minititanium plate, 5 holes, 8 holes and 3 holes, was used. The wound within the nasal passages, maxillary sinuses and anterior surface of the maxilla was cleaned from fragments and chips of wood. The reconstruction of the tissues and repositioning of the bony fragments were conducted. The Redon drainage tube was implemented in the postoperative cavity, anterior and posterior nasal tamponade (Bellocq type) was required, the wounds in the left cheek and neck were debrided. The patient was discharged in general good condition 7 days on surgery.

The patients with severe injuries within the splanchnocranium and the neck, connected with the penetration of foreign bodies huge in size, should be treated in specialist centres by a multispecialty team of surgeons according to therapeutic standards.