顎関節鏡を用いて弾丸を摘出した顔面の盲管銃創の１例

Abstract

Difficulty in extracting a foreign object embedded in tissue of the oromaxillofacial region is not uncommon. Arthroscopic surgery is often used to treat conditions of the temporomandibular joints. We successfully extracted foreign objects embedded in a cul-de-sac facial gunshot wound adjacent to the temporomandibular joint, using a rigid endoscope originally designed for temporomandibular arthroscopic surgery. The procedures used are described in this report.The patient was a 46-year-old man who had been shot in the left side of the face. The bullet lodged in tissue medial to the left temporomandibular joint and sphenoidal sinus. Without any additional incision, a temporomandibular arthroscope was introduced from the point of entry of the bullet beneath the eye socket with the patient under general anesthesia. A total of 34 objects, including the bullet, its fragments and glass fragments from the patient's eyeglasses, were endoscopically extracted with the use of a grasping forceps. Arthroscopic monitoring permitted visual confirmation of the foreign bodies and enabled their successful extraction with minimal invasion.