Ballistic Projectile in the Retropharyngeal Region with Oropharyngeal Bulging a Case Report

A retained ballistic projectile in the retropharyngeal region may present as oropharyngeal bulging after a cervicofacial gunshot wound. We report the case of a 25-year-old serviceman who sustained a gunshot injury to the left chin region during an attack on his operational base. Clinical examination showed a healed punctiform entry wound, bulging of the posterior oropharyngeal wall, and uvular deviation. Cerebral and cervicofacial computed tomography performed 24 hours after the injury identified a metallic projectile near the skull base, approximately 14 mm from the upper part of the clivus. Initial treatment comprised broad-spectrum antibiotics, analgesia, and resuscitative measures. Two weeks after the injury, the projectile was removed through a direct transoral approach under general anesthesia. Recovery was uneventful, with no hemorrhagic or infectious complications and no functional sequelae at one-year follow-up. Although spontaneous migration was reported in the source case description, serial imaging demonstrating displacement was not provided. This case documents successful transoral extraction of an accessible projectile; the timing and anatomical course of the reported migration require confirmation.