LOW-VELOCITY GUNSHOT WOUNDS TO THE PARANASAL SINUSES

There are more than 200 million private firearms in the United States today. Firearm-associated deaths are the second leading cause of morta lity for men 1 to 38 years of age. There are many studies in the liter ature concerning the management of high-velocity gunshot injuries to t he head and neck. However, there are no studies in the English languag e literature concerning the management of isolated low-velocity gunsho t wounds to the paranasal sinuses. We retrospectively reviewed 35 pati ents treated for low-velocity gunshot wounds of the paranasal sinuses between 1985 and 1994 at Kings County Hospital Center. The injuries su stained by these patients were less severe than previously reported fo r high-velocity missile or shotgun injuries. The management of these i njuries is outlined with emphasis on (1) indications for angiographic studies, (2) airway management, and (3) indications for operative remo val of bullet fragments.