Intraoperative navigation assisted reconstruction of a maxillo-facial gunshot wound

Abstract

This case report describes a suicidal gunshot wound to the head using a handgun (9 x 19 mm). During mandibular penetration, the solid hollow point projectile (Aktion4) was deformed but did not fragment. The mandible, mid-face, orbit, and nasal complex were severely damaged. Here, the authors present, for the first time, a new approach for bilateral mid-facial fractures. For virtual reconstruction, a naso-orbito-ethmoidal complex of an unaffected skull (same age, sex, and ethnic group) was merged into the computed tomography (CT) data set. Based on this data set, a navigation assisted operation was performed. The favorable outcome leads us to recommend the technique of merging comparable CT data for reconstructive planning of bilateral mid-facial fractures.