Vol.96 No.10 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.10 October 2003
A Case of Gunshot Wound Penetrating from Face to Neck
Shigetaka Moriai and Hiroshi Shigyou
(Wakkanai City Hospital, Asahikawa Medical College)
Shigeru Saitoh
(Wakkanai City Hospital)
Yasuaki Harabuchi
(Asahikawa Medical College)
We report the case of a 19-year-old female with a gunshot wound penetrating from face to neck, caused by a handgun in Wakkanai City, Hokkaido.
Upon arrival at our hospital, she was conscious and in good general condition. We found wounds on her right face and left neck, and suspected gunshot injury from the defect of skin with burns around the wound on her face. Injuries to the basal part of the right inferior turbinate, the bottom of the left tonsil, and the center of the hard palate were seen. From the skin defect, we concluded that the bullet penetrated from face to neck, passing through the right maxillary sinus, nasal cavity and oral cavity. After the operation to suture the wound under general anesthesia, we found paralysis of the left glossopharyngeal, vagus and hypoglossal nerves and sympathetic trunk as shown by dysphagia, hoarseness, deviation of tongue, and Horner's syndrome. She achieved oral intake of jelly after 3 weeks of swallowing training, and 15 months later, she recovered from the paralysis.
We decided that the important arteries and veins in her neck weren't destroyed by the bullet. Among domestic reports of gunshot wounds, there were no cases of paralysis of multiple cranial nerves except for our case.
Key words : gunshot wound, paralysis, Horner's syndrome, cranial nerves, face and neck