Submandibular Gland Injury With a Ball Bearing Gunshot Wound

Submandibular gland injury is a rare occurrence that has been only documented in case reports. This is due to its protected location under the mandible, and only penetrating injuries to the floor of the mouth or trauma underneath the mandible can reach and damage it. While pediatric injuries due to non-powder firearms are decreasing yearly, 80.8% of the injuries were due to ball bearing (BB) guns. This case report explores the diagnosis and management of a 16-year-old girl who presented with a BB gunshot wound to the submandibular gland. The anatomy, imaging, and surgical management are detailed, and diagnosis guidelines and treatment options are analyzed and explained. This case highlights the importance of understanding the harm that non-powder firearms are capable of causing despite being perceived as toys.

[1]  Gary A. Smith,et al.  Nonpowder Firearm Injuries to Children Treated in Emergency Departments , 2019, Pediatrics.

[2]  Jeewanjot S. Grewal,et al.  Anatomy, Head and Neck, Submandibular Gland , 2019 .

[3]  S. Kanekar,et al.  Imaging of Submandibular and Sublingual Salivary Glands. , 2018, Neuroimaging clinics of North America.

[4]  I. Tohnai,et al.  Sialendoscopic removal of fish bone-induced sialoliths in the duct of the submandibular gland. , 2017, Auris, nasus, larynx.

[5]  M. Sargon,et al.  Revisiting the relationship between the submandibular duct, lingual nerve and hypoglossal nerve. , 2015, Folia morphologica.

[6]  Rachel Lee,et al.  Pediatric eye injuries due to nonpowder guns in the United States, 2002-2012. , 2015, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[7]  I. Dimitrakopoulos,et al.  Salivary Gland Trauma: A Review of Diagnosis and Treatment , 2012, Craniomaxillofacial trauma & reconstruction.

[8]  M. Nadershah,et al.  Removal of parotid, submandibular, and sublingual glands. , 2012, Oral and maxillofacial surgery clinics of North America.

[9]  J. M. Harbison,et al.  Submandibular gland injury and delayed airway compromise caused by a seat belt. , 2010, American journal of otolaryngology.

[10]  K. Mackway-Jones,et al.  A maximally sensitive clinical decision rule to reduce the need for radiography in mandibular trauma. , 2005, Annals of the Royal College of Surgeons of England.

[11]  D. Laraque.  Injury Risk of Nonpowder Guns , 2018, Pediatric Clinical Practice Guidelines & Policies.

[12]  D. Dattilo,et al.  An unusual supplemental vehicle restraint-induced injury: report of case and review of literature. , 2002, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  E. Orsitto,et al.  Blunt submandibular gland trauma: acute CT findings , 2002, Emergency Radiology.

[14]  D. LeMay,et al.  Imaging of facial trauma. , 2002, Neuroimaging clinics of North America.

[15]  A. Shaha,et al.  Traumatic submandibular salivary gland fistula. , 1995, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  L. C. Hall,et al.  Fractured submandibular gland: CT findings. , 1991, Journal of computer assisted tomography.

[17]  K. Christoffel,et al.  Nonpowder firearm injuries: whose job is it to protect children? , 1987, American journal of public health.

[18]  J. D. de Geus,et al.  A traumatic fistula of the submandibular gland. , 1976, British journal of plastic surgery.