Self-Inflicted Craniofacial Impalement Injury with a Screwdriver During the COVID-19 Pandemic: A Case Report

ABSTRACT Objective: To present a case of a 37-year-old man presenting with craniofacial impalement injury from a screwdriver that happened during the early stages of the COVID-19 pandemic. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Results: During the early stages of COVID-19 pandemic a 37-year-old man was brought to the emergency room with a screwdriver embedded in his right eye. A multidisciplinary team observing available recommendations (level IV PPE, carefully planned operative directives) successfully performed endoscopic endonasal transsphenoidal surgery with application of a nasoseptal Hadad flap and abdominal fat obliteration. Aside from medial gaze limitations of the right eye, there was no CSF leak or rhinorrhea and no neurologic sequelae on follow up. Conclusion: Endoscopic skull base surgery for such an impalement injury as this is a formidable multidisciplinary challenge, even in normal times. The early stages of the COVID-19 pandemic presented additional challenges. Observing evolving guidelines minimized the high risk of exposure for health care workers while maximizing care for the patient.