title: Late oropharyngeal functional outcomes of suicidal maxillofacial gunshot wounds.
abstract: OBJECTIVE
  The aim of this study was to evaluate the long-term aesthetic and functional results of suicidal gunshot injuries using objective methods to identify the residual problems after one-stage reconstruction.
  
  
  METHODS
  Twenty male patients with gunshot injuries resulting from suicide attempts who were treated in the Department of Plastic and Reconstructive Surgery at Gulhane Military Medical Academy were included in the study. The control group was composed of 10 male volunteers. The reconstructions of all involved structures were performed within 1-3 days of the injury. The patients were evaluated both aesthetically and functionally. The Body Satisfaction Scale was used for evaluation of aesthetic appearances of the facial structures. To evaluate swallowing, videofluoroscopy, cine-magnetic resonance imaging, submental electromyography, Functional Endoscopic Evaluation of Swallowing, and submental ultrasound were performed. Perceptual speech analysis was used for speech evaluation.
  
  
  RESULTS
  The Body Satisfaction Scale score was statistically higher in the control group than in patients with both ongoing and completed reconstructions (P < 0.05). Swallowing disturbances and their frequencies were higher in the study group than in the control group. The most frequently observed swallowing disturbance was stasis in the sinuses. The laryngeal elevation and geometric angle of the epiglottis in the study group were statistically lower than in the control group (P < 0.05). The mean amplitude of contraction of submental muscles was lower in the study group than in the control group (P < 0.05). The Multidimensional Voice Program showed statistically significant differences between the treatment and control groups (P < 0.01).
  
  
  CONCLUSIONS
  Objective assessment methods enabled us to retrospectively evaluate the treatment and identify the specific problem underlying functional and aesthetic morbidities.
authors.affiliation: *Department of Plastic and Reconstructive Surgery, Gulhane Military Medical Academy, Ankara, Turkey †Department of Radiology, Okmeydani Training and Research Hospital, Istanbul, Turkey ‡Abdi Ipekci Caddesi, Maltepe Caddesi, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Zor
authors.forename: Andac
authors.initials: A
authors.lastname: Aykan
authors.forename: Unsal
authors.initials: U
authors.lastname: Coskun
authors.forename: Mete
authors.initials: M
authors.lastname: Aksu
authors.forename: Serdar
authors.initials: S
authors.lastname: Ozturk
mesh_terms: D000328:Adult; D003679:Deglutition / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000503:physiopathology* / Q000601:surgery; D009960:Oropharynx / Q000503:physiopathology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013406:Suicide, Attempted; D013997:Time Factors; D014948:Wounds, Gunshot / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult