Controversies. Nancy L. Syndrerman, MD, Editor Gunshot wound to the frontal sinus
✍ Scribed by Dr. J. Michael Key; Thomas Tami; Dr. Paul J. Donald
- Book ID
- 102848471
- Publisher
- John Wiley and Sons
- Year
- 1990
- Tongue
- English
- Weight
- 519 KB
- Volume
- 12
- Category
- Article
- ISSN
- 1043-3074
No coin nor oath required. For personal study only.
✦ Synopsis
A34-year-old man attempted suicide with a shotgun blast to the head. He arrived in the emergency room conscious and aware of his surroundings. Examination revealed a massive soft tissue injury to the right face (Figure 1). The left anterior palate and maxilla were missing, as well as the left globe. Although the supraorbital rim and anterior table of the frontal sinus were shattered, the remainder of the sinus appeared intact. No cerebral spinal fluid (CSF) was evident in the wound. A computed tomographic (CT) scan confirmed the physical findings. No fracture of the posterior table was noted. Most of the wound was closed primarily. A split-thickness skin graft was placed over the soft tissue of the orbital defect. Within 2 weeks, the superior portion of the skin grafi sloughed revealing a hole into the frontal sinus (Figure 2). A CSF leak was evident. The patient was afebrile and there was no evidence of infection.