Submandibular Gland Injury With a Ball Bearing Gunshot Wound

Abstract

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.

Acute Mandibular Swelling Following Blunt Trauma

“…Salivary gland injury is uncommon, and injury to the submandibular gland much less common than injury to the parotid gland due to the protection of the former by the mandible [1,5]. Case reports of submandibular trauma in adults have involved a fishbone [6], motor vehicle accidents [3,[7][8][9], and gunshot wounds [2,10]. Blunt trauma causing submandibular gland injury, also following a fall, has been described in an adult [11].…”

“…Blunt trauma causing submandibular gland injury, also following a fall, has been described in an adult [11]. CT with contrast has been utilized [2,3,8,9]. There are even fewer case reports in young children.…”

“…Submandibular trauma is rare [1][2][3], particularly with an intact mandible [2,3]. Assessment of a child with a neck mass following trauma requires an assessment of the rapidity of onset of the mass, the presence of constitutional or airway symp-toms, associated maxillofacial or dental trauma, and the main anatomic delineation being whether the mass is lateral or midline.…”