Remove the Metal Bullet Fragment Retained in the Cranio-Maxillofacial Region Using a Dynamic Navigation System

Background: Maxillofacial gunshot wounds have been described in peacetime (related to suicide, homicide, or accidental situations) and during wars. Bullets remaining in the body can cause risks such as infection, functional impairment, and even lead poisoning. Case Presentation: The patient is a 66-year-old female who was shot in the right side of her face with a firelock more than 40 years ago. She requested the removal of the residual bullet. Cone beam computed tomography (CBCT) revealed 11 scattered spherical high-density shadows in the right maxillofacial region. The authors imported CT data into the navigation system and planned minimally invasive surgical approaches. Here, the authors demonstrate the process of extracting a bullet from the maxillofacial region using a dynamic navigation system and evaluate the surgical outcome. Conclusions: The use of a dynamic navigation system in the treatment of gunshot blind penetrating wounds of the cranio-maxillofacial region results in the reduction of operative trauma and shortens the time of operative treatment.