CIVILIAN GUNSHOT OROFACIAL INJURY IN A NIGERIAN TERTIARY HOSPITAL: A 10-YEAR RETROSPECTIVE REVIEW

T.A. Akinniyi1, S.B. Aregbesola1,2,B.A. Famurewa1,2, A.G. Akomolafe1

  1. Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospitals’ Complex, Ile – Ife, Osun State, Nigeria.
  2. Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile – Ife, Osun State, Nigeria.

Abstract

Background: Gunshot related injuries to the face are relatively rare in peacetime. This study reported the pattern of presentation and management of orofacial civilian gunshot injuries at a Nigerian tertiary hospital.

Methodology: Medical records of 25 patients who sustained gunshot injuries to the face and were managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife between 2010 and 2019 were reviewed. Patients’ demographics, wounding mechanisms, clinical presentations and treatment administered were retrieved from the patients’ case record. Patient records with incomplete information were excluded. Data generated were inputed into IBM-SPSS version 26 and analysed.

Results: A total of 2,847 patients were admitted through our department over the study period and 28 of them sustained orofacial gunshot injuries, giving a prevalence of 0.98%. Twenty-five out of the 28 retrieved case files met the inclusion criteria. There were 22 males and 3 females; with a male to female ratio of 7.3:1. The mean age was 37.60 ±11.86 years with highest prevalence at fourth decade of life. About two-thirds of these injuries were intentionally inflicted by others with the use of Dane guns on highways. Majority (64%) of these injuries involved the middle third of the face. Definitive treatments ranged from simple to complex reconstructive procedures to restore pre-injury form and functions.

Conclusion: Gunshot injury involving the maxillofacial region is uncommon during peace time. The male gender was predominantly affected and the middle third facial skeleton was the most involved anatomic site. Most of the injuries were intentionally inflicted by others using Dane gun.

Keywords: Civilian, Gunshot, Orofacial, Injury, Nigeria

Correspondence:

Dr. T.A. Akinniyi
Dept. of Oral and Maxillofacial Surgery,
Obafemi Awolowo University Teaching
Hospitals’ Complex,
Ile – Ife, Osun State,
Nigeria
Email: drtaofeek17@gmail.com

Date of Acceptance: 30th Dec., 2022

Introduction

The orofacial region is one of the vulnerable regions of the body following gunshot injuries. It is one of the body parts that is poorly protected against gunshot related injuries 1 . In 2001, the World Health Organization (WHO) declared gunshot injury as a public health problem because of its significant short and long term consequences on the victims1 . Injuries resulting from gunshots to the face may present with functional impairment and disfigurement.2

Gunshot wounds include wound arising from bullets, pellets, shrapnel and other projectiles. The epidemiology of gunshot injuries varies from one geographical location to another, even within the same country, different nations and between peacetime and wartime or civil unrest.3 Peacetime gunshot injuries are experienced in the following situations – attempted suicides, criminal attacks (armed robbery), terrorist attacks, accidental discharge of gunshots by law enforcement agents, political thuggery and other social unrest and disturbances. Wartime injuries on the other hand occur in region of the world where there is tribal or ethnic or religious conflicts, banditry and insurgency. In wartime, gunshot injuries occur in addition to blast injuries because of the use of bomb, shell, grenades, land mines and improvised explosive devices (IED). The previous studies done by Ugboko et al.4 in Ile-Ife, and Obeichena and Fasola5 in Ibadan were conducted well over two decades ago. Due to increasing population, changes in sociopolitical, security and economic situations of the country at large with implications on our local community, there is need to reappraise the prevalence and presentation pattern of civilian orofacial gunshot injuries in the presence of the heightened economic difficulties and insecurity with the aim of evaluating present preventive strategy and formulating a new policy to tackle the menace of gunshot injuries. Therefore, the purpose of this article was to report the pattern of presentations and management of orofacial civilian gunshot injuries at a suburban Nigerian tertiary hospital.