Turkish Neurosurgery 2014 , Vol 24 , Num 3
Penetrating Gunshot Wound to the Head: Transotic Approach to Remove the Bullet and Masseteric-Facial Nerve Anastomosis for Early Facial Reanimation
Pasquale DONNARUMMA1, Roberto TARANTINO1, Paolo GENNARO2, Valeria MITRO2, Valentino VALENTINI2, Giuseppe MAGLIULO3, Roberto DELFINI1
1Sapienza University of Rome, Department of Neurosurgery, Rome, Italy
2Sapienza University of Rome, Department of Maxillofacial Surgery, Rome, Italy
3Sapienza University of Rome, Department of Otorhinolaryngology, Rome, Italy
DOI : 10.5137/1019-5149.JTN.7325-12.1 INTRODUCTION: Gunshot wounds to the head (GSWH) account for the majority of penetrating brain injuries, and are the most lethal. Since they are rare in Europe, the number of neurosurgeons who have experienced this type of traumatic injury is decreasing, and fewer cases are reported in the literature.

CASE: We describe a case of gunshot to the temporal bone in which the bullet penetrated the skull resulting in the facial nerve paralysis. It was excised with the transotic approach. Microsurgical anastomosis among the masseteric nerve and the facial nerve was performed.

CONCLUSION: GSWH are often devastating. The in-hospital mortality for civilians with penetrating craniocerebral injury is very high. Survivors often have high rate of complications. When facial paralysis is present, masseteric-facial direct neurorraphy represent a good treatment. Keywords : Gunshot wound, Head trauma, Facial palsy, Masseteric-facial neurorraphy

Corresponding author : Pasquale Donnarumma, padonnarumma@hotmail.it