case_images: PMC10499282_01
case_images: (a) Image depicting the extensive facial injury following a gunshot wound (b) Image of the patient post-primary closure of the defect in the emergency bay area. (c) Three-dimensional comminuted fractures of the maxilla, mandible and floor of the orbit (d) Image of the patient post-layered repair and open reduction and internal fixation of the mandible
case_images: AMS-13-120-g001.jpg
case_images: PMC10499282_01_AMS-13-120-g001.jpg
case_images: ams_31_23-f001
case_images: A 35-year-old male patient suffering from depression presented with an alleged history of an accidental high-velocity gunshot wound to the face, leading to an extensive open burst injury extending from the mandible to the base of the skull [Figure 1a]. His vitals gradually stabilised, and he underwent primary closure of the defect under local anaesthesia in the emergency area [Figure 1b]. A computed tomography scan with three-dimensional reconstruction revealed comminuted fractures of the bilateral maxilla and the mandible [Figure 1c]. The tip of the FOB was then manoeuvred around the distorted anatomy, through the vocal cords, and the endotracheal tube was secured, following which rocuronium (70 mg) was administered. The patient then underwent debridement and layered soft tissue repair and intermaxillary fixation with a 25-reconstruction plate [Figure 1d].