Combat-related craniofacial and cervical injuries: a 5-year review from the British military.

BACKGROUND: Recent international publications have noted a sustained increase in the incidence of head, face, and neck (HFN) wounds in comparison with total battle injuries from the 20th to the 21st century. The aim of this review was therefore to perform an analysis of the epidemiology of all HFN injuries sustained by British forces in Iraq and Afghanistan from March 1, 2003, to December 31, 2008. METHODS: Descriptive injury data for this research were obtained from the Joint Theater Trauma Registry and overall battle injury and evacuation figures from the Defense Analytical and Statistical Agency. RESULTS: During this period, 448 servicemen sustained injuries to their HFN. A total of 71% of HFN injuries were sustained in battle. Of all service personnel sustaining HFN injuries, 32% died before the field hospital and a further 6% died subsequently. A total of 73% of injuries required evacuation back to the United Kingdom, whereas 27% of injuries were managed definitively in the theater of operations. HFN injuries altogether were found in 29% of battle injuries between 2006 and 2008. CONCLUSIONS: The individual incidences of head (15%) and face (19%) injuries in relation to total battle injuries, although greater than seen in previous United Kingdom conflicts, were only slightly higher than that seen by US forces. The incidence of neck injury alone in relation to total battle injuries of 11% in United Kingdom forces in comparison with 3% to 5% found in US forces warrants further investigation. This article also provides further evidence to support the existing published opinion of multiple international authors in the requirement to develop innovative methods of protecting the vulnerable HFN regions.

Cranial osteomyelitis: a late complication of a dental infection.

Dental infections are associated with a range of serious complications. The orofacial region provides potential spaces in the tissue that infections of dental origin can occupy. We describe the subtemporal extension of a dental infection, the late development of cranial osteomyelitis, and its surgical management.

Oral mucosal response to exposure to diquat: a rare occupational injury.

Diquat is a quaternary ammonium herbicide closely related to paraquat, and is used commonly by commercial and domestic gardeners. The systemic toxicity of this group of compounds is well-known, but isolated human oral mucosal responses to topical exposure are not well-reported. We present details of an accidental mucosal exposure to diquat during manufacture and the resultant injury, and give guidance for appropriate management of such an exposure.