Severe Craniofacial Morbidity from a Bean Bag Projectile

Summary. Bean bag munitions, less-lethal weapons primarily used by law enforcement, can cause severe morbidity. Although bean bag munitions are less likely to cause severe injury when compared with regular gunshot rounds, it is crucial to understand that bean bag munitions may be life-threatening. In this case, we describe our experience with a patient who suffered a zygomaticomaxillary complex fracture, facial nerve injury, and retained munition round in his maxillary sinus from a bean bag projectile shot during an altercation with the police. The patient was urgently transferred to the operating room for extraction of the bean bag munition, and although fracture repair was successful, the patient sustained significant damage to facial nerves, leading to lagophthalmos. To our knowledge, this is the first case report describing a penetrating injury from a bean bag munition that was retained within a facial structure. We will discuss the surgical intervention used for this patient and the review of the current literature on these less-lethal munitions.