Description

A 20-year-old man reported to the outpatient clinic, with concerns regarding a 10×13 mm glass fragment that had allegedly expulsed from his right cheek wound 10 days prior (figure 1). His medical records revealed that he had sustained a road traffic accident (RTA) and had been operated for fractures of the mandible 3 weeks earlier. He was unable to recollect the exact nature of the facial injury, allegedly due to a short spell of unconsciousness following the incident.

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Figure 1

Laceration wound (left) and expulsed glass fragment (right).

Clinical examination revealed a 12 mm scar in the cheek near the right ear lobule, reminiscent of a healed laceration wound (figure 1). No tenderness or discharge was noted. There were no other relevant extraoral or intraoral findings. Close scrutiny of the presurgical dental panoramic radiograph revealed radio-opacity in the right mid-ramus region, matching the outline of the glass fragment (figure 2).

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Figure 2

Dental panoramic radiograph showing embedded glass fragment.

Corroborating the above findings, it was speculated that the glass piece had lodged in the subcutaneous plane of the right cheek during the injury and had then uneventfully expulsed during wound healing due to proximity to the surface. Irrespective of whether the radiographic finding was missed or ignored, it reminds us of two facts. First, most glass bodies are radio-opaque and detectable in a radiograph.1 Second, and more importantly, the need for careful assessment of all RTA-associated injuries for embedded foreign bodies cannot be overstressed.2