Penetrating knife injury to infratemporal region: case report and review of literature

Abstract

Infra Temporal Fossa (ITF) injuries with retained knife handle are quite uncommon. ITF has a complex anatomy and is divided into prestyloid and post styloid compartments. We reviewed the literature and found one reported case. We are presenting another such rare case. A 22-year-old male presented in emergency room with a retained knife injury to the left face in front of left tragus. Clinically the patient was stable haemodynamically. CT showed the knife lying in left extra cranial infratemporal region, and the tip dangerously close to carotid canal, foramen ovale, and foramen spinosum and lateral orbital wall. After careful assessment it was decided to take the patient for simple extraction of knife in OT and prepare neck for ligation of external carotid if required. The knife was successfully removed and the patient has been followed up for 1 year with no residual problems. ITF injuries are uncommon and dangerous particularly ones which go into retrostyloid region and penetrate cranial cavity. If patient is stable clinically and imaging suggests pre styloid ITF injury, then after consulting a multidisciplinary team these may be treated by simple knife extraction in operation theatre with good outcome.