title: The surgical treatment of reinforced steel bar injury penetrating the skull base and maxilla-mandibular area.
abstract: Penetrating injuries with reinforced screwed steel bar in the skull base represent a unique challenge for oral maxillofacial surgeons. Management of these injuries is complicated by associated injuries and the proximity to vital neurovascular structures. A 35-year-old man was admitted to our hospital because of injury due to a downward fall upon a reinforced steel rod. Radiologic studies of the skull base revealed that the steel bar traversed the temporomandibular space between the left cervical spine and the mastoid process to the space between the inner side of the left mandibular ramus and the maxilla. We performed osteotomy of the left mastoid process tip and the left mandibular ramus to take out the steel bar from the maxilla and repaired the left mandible with internal fixation. Appropriate preoperative planning, including three-dimensional computed tomographic images, is integral in the surgical approach for the safe removal of such objects.
authors.affiliation: From the *Stomatological Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; †School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; and ‡The Orthopaedic Department, the 2nd Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
authors.forename: Yanliang
authors.initials: Y
authors.lastname: Wang
authors.forename: Lini
authors.initials: L
authors.lastname: Pan
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
mesh_terms: D000328:Adult; D003252:Construction Materials; D005547:Foreign Bodies / Q000175:diagnosis* / Q000601:surgery*; D005593:Fracture Fixation, Internal; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008338:Mandibular Injuries / Q000175:diagnosis* / Q000601:surgery*; D008437:Maxilla / Q000293:injuries* / Q000601:surgery*; D008443:Maxillary Sinus / Q000293:injuries* / Q000601:surgery; D019838:Neck Injuries / Q000175:diagnosis / Q000601:surgery*; D060051:Occupational Injuries / Q000175:diagnosis* / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D019291:Skull Base / Q000293:injuries* / Q000601:surgery*; D013232:Steel; D014057:Tomography, X-Ray Computed / Q000379:methods; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000601:surgery*
chemical_list: D013232:Steel