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Bulletproof Temporal Bone: A Case of Self-Inflicted Ballistic Injury

2023-05Journal article Open access
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dc.contributor.authorCasanova, Maria J
dc.contributor.authorTavares Correia, João
dc.contributor.authorLino, João
dc.contributor.authorMagalhães, António
dc.contributor.authorMeireles, Luis
dc.date.accessioned2024-06-17T15:11:45Z
dc.date.available2024-06-17T15:11:45Z
dc.date.issued2023-05
dc.description.abstractTemporal bone injuries due to gunshot wounds are uncommon but devastating, with a high risk of damage to critical neurovascular structures. The high resistance of the temporal bone, the densest bone in the human body, can sometimes avoid a fatal outcome. However, the complications are in many cases devastating and include hearing loss, facial paralysis, cerebrospinal fluid leakage, intracranial damage, and vascular injuries. Our goal was to report a case of ballistic injury to the temporal bone and describe the surgical approach taken for treatment. A 74-year-old man was transferred to the emergency room of our tertiary hospital, intubated and sedated, after an attempted suicide with a firearm. The CT scan showed the metal projectile lodged within the temporal bone on the right side, with the destruction of the ossicular chain and bony labyrinth. After stabilization, sedation was reversed, and the otolaryngology team was called. On examination, the entry wound was located in the cavum concha, with no active bleeding but presenting active otorrhea of cerebrospinal fluid. The patient had complete peripheral facial paralysis on the right side and spontaneous horizontal nystagmus toward the left side. Empirical antibiotic therapy was initiated. A subtotal petrosectomy was performed, with the removal of the foreign body, repair of the cerebrospinal fluid fistula, obliteration of the cavity with abdominal fat, and closure of the external auditory canal. He was discharged on the 11th-day post-surgery, maintaining complete facial paralysis and right-side anacusis, but was able to walk with assistance. In conclusion, penetrating trauma of the temporal bone is a potentially life-threatening situation, and patients that survive have a guarded prognosis, as it often leads to permanent sequelae even when managed promptly.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCasanova MJ, Correia JT, Lino J, Magalhães A, Meireles L. Bulletproof Temporal Bone: A Case of Self-Inflicted Ballistic Injury. Cureus. 2023;15(5):e38500. doi:10.7759/cureus.38500pt_PT
dc.identifier.doi10.7759/cureus.38500pt_PT
dc.identifier.issn2168-8184
dc.identifier.urihttp://hdl.handle.net/10400.16/2931
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCureus, Inc.pt_PT
dc.relation.publisherversionhttps://www.cureus.com/articles/153165-bulletproof-temporal-bone-a-case-of-self-inflicted-ballistic-injury#!/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectbullet injurypt_PT
dc.subjectcerebro-spinal fluid fistulapt_PT
dc.subjectfacial nerve paralysispt_PT
dc.subjecttemporal bone surgerypt_PT
dc.subjecttemporal bone traumapt_PT
dc.titleBulletproof Temporal Bone: A Case of Self-Inflicted Ballistic Injurypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceUnited States of Americapt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPagee38500pt_PT
oaire.citation.titleCureuspt_PT
oaire.citation.volume15pt_PT
person.familyNameTavares Correia
person.givenNameJoão
person.identifier.orcid0009-0004-6216-2221
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationd612d2ec-04cc-44f9-b216-e3d9f0d2f8e7
relation.isAuthorOfPublication.latestForDiscoveryd612d2ec-04cc-44f9-b216-e3d9f0d2f8e7

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