A Case of Penetrating Craniomaxillofacial Injury in the Time of COVID-19

Authors

DOI:

https://doi.org/10.32412/pjohns.v40i.1621

Keywords:

foreign body, metal impalement, temporal lobe, maxillary sinus, internal maxillary artery, middle cerebral artery, subtemporal fossa, infratemporal fossa

Abstract

Objective: To describe a case of a craniomaxillofacial penetrating injury focusing on the importance of a multidisciplinary approach with insights into the surgical planning for successful removal of the foreign body during the pandemic.

Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Patient: One

Results: A 15-year-old boy presented with a work-related puncture wound in the right nasomaxillary area with accompanying soft-tissue swelling. Physical examination of his face showed no external foreign body. Craniofacial computed tomography scans revealed a rodshaped opaque foreign body about 12 cm in length and 9 mm in diameter lodged in the right maxillary sinus extending to the right temporal lobe. The otolaryngology-head and neck surgeon
and neurosurgeon planned the crucial extraction of the foreign body, but the requirement for a negative RT-PCR, blood products, and additional imaging delayed this emergent operation. The foreign body was eventually removed via combined trans-antral approach and right frontotemporal craniotomy, zygotomy, and craniectomy around the foreign body in the temporal floor with duraplasty and cranioplasty.

Conclusion: Successful treatment of penetrating craniomaxillofacial injuries involves diligent clinical assessment, radiologic diagnosis and a well-planned multidisciplinary surgical approach. Delays in treatment may be beneficial if they allow precise location of the foreign body and thorough evaluation of involved structures. Safeguarding the healthcare workers during the pandemic was as important as ensuring a successful and safe surgery for the patient.

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Published

2025-09-20

How to Cite

1.
Baccay OG, Santos-Perez J, Amable JP. A Case of Penetrating Craniomaxillofacial Injury in the Time of COVID-19. Philipp J Otolaryngol Head Neck Surg [Internet]. 2025 Sep. 20 [cited 2026 May 2];:17-20. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/1621

Issue

Vol. 40 Supplement (2025): Philippine Journal of Otolaryngology Head and Neck Surgery

Section

Case Reports

License

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