Epidemiology of Maxillofacial Gunshot Injuries at Chris Hani Baragwanath Academic Hospital.

Background: Facial gunshot wounds (FGSWs) represent a complex form of maxillofacial trauma with significant functional and psychological implications. However, epidemiological data on their presentation and outcomes remain limited.

Objective: To describe the epidemiology and pattern of civilian facial gunshot injuries treated at Chris Hani Baragwanath Academic Hospital.

Methods: A retrospective cohort study was conducted on patients with FGSWs treated at Chris Hani Baragwanath Hospital's Maxillofacial and Oral Surgery departments from January to December 2021. Injuries were classified by location, soft tissue involvement, and fracture type. Demographic and injury-related variables such as injury location, number of GSW, and type of gunshot injuries were recorded. Categorical data were summarized using frequencies and percentages, and associations were assessed using Fisher exact test, with significance set at P ≤ 0.05.

Results: Of the 1303 gunshot patients, 121 (9.3%) had FGSW (108 males and 13 females). Ages of 20 to 39 constituted about 72.8% of the patients. The majority of FGSW were penetrating injuries (60%), single-shot wounds (73.6%), and 52.1% had intraoral communications. The mandible was the most frequently fractured bone. Most of the FGSWs were in zone 3 level and were mostly penetrating (60%) in nature. Patients with an isolated avulsion pattern of injury and floor of the mouth injury associated with mandibular fractures significantly compromised the airway.

Conclusions: This study highlights the significant burden of maxillofacial injuries caused by gunshot wounds. FGWs are most observed in young adult males. Patients presenting with avulsion-type mandibular injuries or floor of the mouth involvement associated with mandibular fractures are at increased risk of airway compromise and should be monitored for signs of deterioration.