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Facial Reconstruction after a Complicated Gunshot Injury

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Author(s): Vanna Long | Lun-Jou Lo | Yu-Ray Chen

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 25;
Issue: 08;
Start page: 557;
Date: 2002;
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Keywords: gunshot injury | facial reconstruction | multidisciplinary management

ABSTRACT
Facial gunshot injuries are unusual and complicated clinical entities. Because of themechanism of injury, early aggressive primary reconstruction might not be ideal. Initial conservativemanagement followed by staged secondary reconstruction could be performed toobtain satisfactory functional and aesthetic results. Reconstruction of the cranio-maxillofacialdeformities requires a multi-disciplinary approach, the same way as for patients withcleft lip/palate deformities. We present a male patient with severe facial gunshot injuries. Ateam approach revealed maxilla recession, dental malocclusion, a large oronasal fistula overhis hard palate, velopharyngeal insufficiency, and a stable psychosocial status. His mainconcern was facial appearance, which included the nose, lip, and scars. Staged reconstructionswere performed, consisting of orthognathic surgery, rhinoplasty, lip-switch flap, andrevisions of scars. A satisfactory outcome was obtained. The results indicated the importanceof preoperative evaluation and treatment planning for this uncommon problem.
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