title: Penetrating injury of the cheek requiring skull base exploration.
abstract: We report a case of a very unusual penetrating injury of the middle third of the face. The patient was involved in a road traffic accident, and the indicator control lever became impaled in his right cheek. There was contralateral orbital damage resulting in loss of sight. The cribriform plate was breached and a pneumoencephalocele ensued. We discuss the modern management of such injuries including injury assessment. We emphasize the importance of crash scene information gathering and analysis of injury mechanisms. Facial injury zonal classification and imaging are reviewed in the context of the case. We discuss the reasons that led us to treat this patient via the subcranial approach.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, St Mary's Hospital, London, UK. nnpatel2000@hotmail.com
authors.forename: N N
authors.initials: NN
authors.lastname: Patel
authors.forename: S C
authors.initials: SC
authors.lastname: Wang
authors.forename: L
authors.initials: L
authors.lastname: Marentette
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D002610:Cheek / Q000293:injuries*; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D019291:Skull Base / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed