Trauma bucomaxilofacial por arma de fogo: condutas emergenciais, reconstrução e implicações clínicas
DOI:
https://doi.org/10.34119/bjhrv9n1-073Keywords:
ferimentos por arma de fogo, traumatismos maxilofaciais, mandíbula/lesõesAbstract
Os ferimentos por arma de fogo na região bucomaxilofacial apresentam elevada complexidade devido ao risco imediato de comprometimento das vias aéreas, hemorragia e destruição tecidual. A abordagem atual prioriza estabilização rápida, com auxílio de tomografia computadorizada para avaliação precisa e intervenção cirúrgica precoce, incluindo desbridamento cirúrgico e reconstrução primária, com finalidade de redução das taxas de complicações, danos estéticos e funcionais ao paciente. O caso relatado demonstra o manejo de fratura mandibular por projétil de arma de fogo em adulto jovem, evidenciando a importância da atuação multidisciplinar para recuperação funcional e estética. A literatura reforça que intervenções precoces reduzem complicações e melhoram o prognóstico.
References
ABRAMOWICZ, S. et al. Facial fractures in patients with firearm injuries. Journal of Oral and Maxillofacial Surgery, v. 75, n. 10, p. 2092–2101, 2017.
BENATEAU, H.; CHATELLIER, A.; CAILLOT, A.; LABBE, D.; VEYSSIERE, A. Computer-assisted planning of distraction osteogenesis for lower face reconstruction. Journal of Craniomaxillofacial Surgery, v. 44, n. 11, p. 1801–1806, 2016.
BREEZE, J.; TONG, D.; GIBBONS, A. Contemporary management of maxillofacial ballistic trauma. British Journal of Oral and Maxillofacial Surgery, v. 55, n. 7, p. 661–665, 2017.
CHATTHA, A.; LEE, J. C.; JOHNSON, P. K.; PATEL, A. An algorithmic approach to the management of ballistic facial trauma in the civilian population. Journal of Craniofacial Surgery, v. 29, n. 8, p. 2010–2016, 2018.
ELEGBEDE, A.; WASICEK, P.; MERMULLA, S. et al. Survival following self-inflicted gunshots to the face. Plastic and Reconstructive Surgery, v. 144, n. 2, p. 415–422, 2019.
ESER, C.; GENCEL, E.; KESIKTAŞ, E.; YAVUZ, M. Outcomes of anatomic reconstruction of gunshot-inflicted lower face defects by free fibula flap. Journal of Craniofacial Surgery, v. 27, n. 5, p. 1139–1142, 2016.
GRUNLUOGLU, R.; GATHERWRIGHT, J. Microsurgical reconstruction of complex maxillofacial gunshot wounds. Microsurgery, v. 39, n. 5, p. 384–394, 2019.
GUEVARA, C.; PIRGOUSIS, P.; STEINBERG, B. Maxillofacial gunshot injuries: a comparison of civilian and military data. Journal of Oral and Maxillofacial Surgery, v. 74, n. 4, p. 795.e1–795.e7, 2016.
JOSE, A.; ARYA, S.; NAGORI, S. High-velocity ballistic injuries inflicted to the maxillofacial region. Journal of Craniofacial Surgery, v. 30, n. 6, p. e511–e514, 2019.
MAURIN, O. Maxillofacial gunshot wounds. Prehospital and Disaster Medicine, v. 30, n. 6, p. 1–3, 2015.
MOMENI ROOCHI, M.; RAZMARA, F. Maxillofacial gunshot injuries and their therapeutic challenges: case series. Clinical Case Reports, v. 8, n. 6, p. 1094–1100, 2020.
MURPHY, J. A.; MCWILLIAMS, S. R.; LEE, M.; WARBURTON, G. Management of self-inflicted gunshot wounds to the face. British Journal of Oral and Maxillofacial Surgery, v. 56, n. 3, p. 173–176, 2018.
NORRIS, O.; MEHRA, P.; SALAMA, A. Maxillofacial gunshot injuries at an urban level I trauma center—10-year analysis. Journal of Oral and Maxillofacial Surgery, v. 73, n. 8, p. 1532–1539, 2015.
SINNOTT, J. D.; MORRIS, G.; MEDLAND, P. J.; PORTER, K. High-velocity facial gunshot wounds: multidisciplinary care from prehospital to discharge. BMJ Case Reports, v. 2016, p. bcr2015213268, 2016.
VACA, E. E.; BELLAMY, J. L.; SINNO, S.; RODRIGUEZ, E. D. Management of high-energy avulsive ballistic facial injury: a review of the literature. Plastic and Reconstructive Surgery Global Open, v. 6, n. 7, p. e1693, 2018.
VATSYAYAN, A.; ADHYAPOK, A. K.; DEBNATH, S. C. et al. Reconstruction and rehabilitation of short-range gunshot injury to lower part of face: a systematic approach of three cases. Chinese Journal of Traumatology, v. 19, n. 4, p. 232–235, 2016.
VOLK, A. S. et al. Facial gunshot wounds. Facial Plastic Surgery, v. 35, n. 6, p. 582–594, 2019.
