Facial plast Surg 2005; 21(3): 191-198
DOI: 10.1055/s-2005-922859
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Gunshot Wounds to the Face-Acute Management

J. Nicolas McLean1 , Charles E. Moore1 , 2 , Seth A. Yellin1 , 3
  • 1Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia
  • 2Grady Memorial Hospital, Atlanta, Georgia
  • 3Emory Healthcare, Atlanta, Georgia
Further Information

Publication History

Publication Date:
23 November 2005 (online)

ABSTRACT

The complex facial trauma victim poses a genuine therapeutic challenge as a whole, and may be particularly challenging to the medical team. The literature on acute management of gunshot wounds to the face is scarce. We performed an extensive review of the English-language literature in an effort to better delineate the diagnosis and acute management of these injuries.

Most of these injuries do not present with initial threat to life and can safely be managed non-operatively. Definitive treatment is often deferred in patients with multiple, or more severe, injuries. Airway compromise is the most frequent and most life-threatening early problem reported in most series. CT scan remains the most useful method in the evaluation of these types of injuries and associated cervical spine lesions. Facial bleeding is best controlled by angiography and subsequent embolization. Anatomic repair of soft tissue and bony injuries is recommended to obtain an optimal functional and aesthetic outcome. Despite the creation of some algorithms, no clear correlation has been found between the site of enterence wound and the injuries and outcome of gunshot wounds to the face.