Clinical case report: a patient with gunshot wounds in the maxillofacial region

In recent times, gunshot injuries of the maxillofacial area are challenge of modern medicine. The main causes are criminal injuries, the second is suicide attempts and the third is careless and ignorant handling of weapons. Maxillofacial gunshot injuries require proficiency to determine a suitable treatment plan and surgical intervention. Treatment in these patients is very challenging. Moreover, posttreatment infections are a serious problem in such cases. Thus, step‐by‐step surgery is essential to obtain a better result in these patients. The majority of maxillofacial gunshot wounds are caused by suicide attempts. Today the gunshot wounds were caused mainly by assaults (37.3%), followed by aggression (33.3%), attempted homicide (26.7%) and attempted suicide (2.7%). There was a predominance of the 21-to-30-year age group (38.7%) and the male gender (92%). A case: it was a suicide attempt by smoothbore gun. A 38 years old man presented fracture of mandible, defect of soft tissues in the lower jaw, cheek and zygomatic area, with the presence of a large number of foreign bodies (buckshot). The most common clinical signs were pain, edema and trismus. With mandible fractures, paresthesia, increased salivation, malocclusion, bone exposure, deviation of mouth opening and premature contact were noted. When the zygomatic region was affected, otorrhagia, epistaxis, diplopia and paresthesia were noted. In maxillary fractures, Oro-antral and Oro-nasal communication predominated. Finally, the operation was completed without any complications and ended with the desired result. The patient is currently undergoing rehabilitation and has been referred to a plastic surgeon for scar correction. One of the important nuances of such clinical cases is that the patients suffer from the defects caused by severe facial injuries and avoid social interaction. Therefore, restoration of communicative and social function along with satisfactory aesthetic condition and restoration of other physiological functions (chewing, swallowing, speech, breathing) is a big challenge for maxillofacial surgeons today. We agree that gunshot wounds of the maxillofacial area involve extensive damage and require a specific approach in terms of diagnosis and treatment. As for the healing process, its progress depends greatly on the anatomical-physiological features of the damaged area and the severity of the damage.