Facing the challenge maxillofacial penetrating teta injury: A case report

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.