A 39-year-old reservist is currently hospitalized at Beilinson Hospital with an extraordinary injury sustained during military operations in Balata camp. The soldier was shot in the face, with a 0.8-inch long and 0.4-inch diameter bullet entering through his nose and becoming lodged behind his upper wisdom tooth.
This rare injury represents a miraculous survival story – had the bullet's path differed by just a few millimeters, the soldier would have died instantly. The case presented a unique medical dilemma for doctors, who had to decide whether to surgically remove the bullet or leave it permanently in the soldier's mouth. While the reservist complains of pain and difficulty swallowing, doctors must weigh whether a complex and dangerous operation to extract the bullet would actually improve his condition.
Professor Gabriel Chaushu, head of Oral and Maxillofacial Surgery Rabin Medical Center's Beilinson Campus, explained the medical reasoning behind their decision-making process."Our consideration about whether to remove the bullet or not boils down to evaluating benefits versus surgical risks," Professor Chaushu said. "Surgery adds another scar and trauma while potentially causing infections and complications. We're concerned about several risks, including damage to the motor nerve that could cause facial paralysis, blood vessel damage, and injury to the nerve responsible for sensation in the lower jaw and tongue movement."
The team held several expert team discussions throughout the soldier's hospitalization and rehabilitation to examine whether the bullet should be removed. As other issues resolved and the soldier's jaw opening significantly improved through physiotherapy, they ultimately decided to avoid the surgical risks despite the patient's continuing pain complaints.
"After examining all aspects of the case, we believe with very high probability that even if we had decided to perform this complex surgery, the pain would not have stopped," Professor Chaushu said. "The treatment approach for this case focuses on pain management, with the hope that over time, the body will adapt to the new situation and the pain will gradually decrease."
The professor shared that he gained his extensive experience with facial gunshot wounds through a fellowship at Jackson Memorial Hospital in Miami. "In Miami, gunshot victims arrive at the hospital daily, and I treated dozens of shooting injuries with bullets inside the mouth. The biggest lesson I learned there is that in gunshot wounds, tissue undergoes necrosis due to heat, and when you open it, there's risk of infections requiring additional surgeries. Therefore, it's better not to rush into action but to proceed slowly and methodically."
