An unusual craniofacial injury. A case report

Area of Science:

• Trauma surgery
• Otolaryngology
• Neurosurgery

Background:

• Penetrating craniofacial injuries are rare but can cause severe damage.
• Speargun injuries present unique challenges due to projectile characteristics and anatomical location.
• This case highlights the importance of rapid surgical intervention.

Observation:

• A 13-year-old boy sustained a penetrating craniofacial injury from a speargun harpoon.
• The harpoon traversed the nasal ala, maxillary sinus, and nasopharynx, nearing the atlas.
• The injury had a horrific appearance but minimal initial neurological and vascular compromise.

Findings:

• Successful retrieval of the speargun harpoon was achieved through a combined lateral rhinotomy/Caldwell-Luc approach.
• Despite the extensive trajectory, no significant neurological deficit was observed.
• Vascular findings were minimal, indicating successful management of potential hemorrhage.

Implications:

• This case demonstrates the potential for favorable outcomes in severe penetrating craniofacial injuries with prompt surgical management.
• The combined lateral rhinotomy/Caldwell-Luc approach is effective for retrieving deep facial projectiles.
• Early intervention is crucial in preventing secondary complications like infection or further neurovascular damage.