Abstract
Background: Shots from commonly available non-gunpowder weapons are a significant cause of facial injuries, especially in pediatric patients. A consequence of such trauma may be the placement of a projectile within the maxillary sinus, which is a therapeutic need with no guidelines for foreign body removal. The purpose of this paper is to discuss the etiology, epidemiology, diagnosis, treatment and prognosis of such cases. Materials and methods: Any cases describing the presence of airgun pellets within the maxillary sinus were included. Animal patients and non-English cases were excluded. The final search using the PubMed, BASE and Google Scholar engines was made on 13 November 2021. The JBI Critical Appraisal Checklist for Case Reports was used to assess the risk of bias. The collected data are presented in tabular form and were subjected to a comparative assessment. Results: In total, reports of seven cases of lead airgun projectiles in the maxillary sinuses were identified, qualified and analyzed. There were no cases of lead intoxication. The bullets were removed by open surgery in the form of antrostomy of the maxillary sinus or with the use of an endoscope. In none of the described cases were complications observed during surgery or postoperative observation. Discussion: This systematic review was based on case reports that differed significantly in quality. The location of the lead foreign body within the maxillary sinuses may be considered favorable over other craniofacial gunshots. The risk of lead intoxication does exist, but such a location of the bullets does not favor it. The removal of projectiles from the maxillary sinuses appears to be easily achievable and does not predispose one to complications.
Highlights
Almost half of the non-powder weapon (NPW) shots in pediatric patients leave a projectile within tissues [1]
The articles describing single and multiple cases of NPWs projectiles within the maxillary sinuses were qualified for the systematic review
Non-powder weapon shots that leave the projectile in the maxillary sinus are rare; they mainly affect children and cause moderate local ailments
Summary
In the group of children over 10 years of age, facial injuries most often occur during sports or as a result of a gunshot with non-powder weapons [1,2]. A non-powder weapon (NPW) is one that uses the force of compressed air or other gas, springs, or electricity to fire a projectile. This category includes: (1) airguns (AGs); (2) airsoft guns; (3) paintball guns [1]. Materials and methods: Any cases describing the presence of airgun pellets within the maxillary sinus were included. Results: In total, reports of seven cases of lead airgun projectiles in the maxillary sinuses were identified, qualified and analyzed. The removal of projectiles from the maxillary sinuses appears to be achievable and does not predispose one to complications
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