Endaural access to remove the projectile from a firearm.
BACKGROUND
Surgical approaches to temporomandibular region have been the subject of numerous controversies in the literature. Pre-auricular approaches have been used with the observance of high success rate, and during surgery history, various modifications of this approach were conducted in order to reduce irreversible sequelae. Thus, given the relevance of the study, this article proposes to alert the professionals that carry out these surgical approaches in relation to the anatomical structures involved and to describe and emphasise the benefits of endaural approach.


METHODS
A Caucasian male patient, victim of a firearm injury, sustained a wound on the right pre-auricular region, and at the time of assessment, he complained of pain, mouth opening difficulty and dysphagia. On physical examination, there was oedema and ecchymosis in the right periorbital region. In the radiological examination, a foreign body compatible with a firearm projectile was observed in the right pre-auricular region, being in accordance with the information collected. The endaural incision and divulsion by plans was then made until the projectile.


CONCLUSIONS
For proper exposure of the region, several studies were designed to evaluate the patterns of branching and anastomosis of the facial nerve. As for the best cosmetic result with the different pre-auricular approaches, the endaural approach was described as an approach that offers great cosmetic results because the incision design guides the surgeon in the wound closure and causes a decrease in the tension of flap, unlike that observed by some authors.
Department of Surgery and Integrated Clinics, School of Dentistry, State of Sao Paulo University, Aracatuba, São Paulo, Brazil. ellengaetti@gmail.com
Ellen Cristina
EC
Gaetti-Jardim
Leonardo Perez
LP
Faverani
Gabriel
G
Ramalho-Ferreira
Cassiano Costa Silva
CC
Pereira
Pedro Ivo Santos
PI
Silva
Idelmo Rangel
IR
Garcia
Elio Hitoshi
EH
Shinohara
D000328:Adult; D001938:Brazil; D004431:Ear, External / Q000293:injuries* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D004954:Esthetics; D020220:Facial Nerve Injuries / Q000517:prevention & control; D005389:Firearms; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D008297:Male; D038781:Otoscopy; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000601:surgery*