Head and neck war injuries: 10-year experience at the American University of Beirut Medical Center.

Lebanon has witnessed over the past 10 years fierce outbreaks of violence resulting in heavy casualties. Head and neck injuries secondary to bullets, shrapnel, and/or glass were quite frequent: 1,357 injuries in 1,021 patients were taken care of by members of the Department of Otolaryngology between 1975 and 1984. They were distributed as follows: (Formula: see text). Fractures of the mandible were treated by closed reduction in 54% of cases and by open reduction in 46%; 74% healed well and 26% required secondary surgery. Primary repair of oral cavity injuries resulted in healing in 68% of cases; 32% had dehiscences or fistulae. In around one-third of the orbital injuries, the orbital contents herniated into the maxillary sinus, so orbital floor repairs had to be done with good results in 82% of cases. The nasal fractures were treated by closed reduction in 75% of cases and open reduction when the wound was open in the rest. The overall infection rate was 12%. The most common offending organisms were, in order of frequency, S. aureus, P. aeruginosa, and E. coli.