男,28岁。1981年11月1日用自制鸟枪射击时子弹爆炸,炸伤右侧面部,流血不止。右鼻孔流血较多,左侧颞部跳动性剧痛,无恶心呕吐及昏迷,当日13时急诊入院。检查:神志清楚;右侧鼻旁有“Y”形伤口,通入上颌窦;鼻中隔后段及鼻咽左侧壁有创面,左侧软腭粘膜下淤血,软腭活动受限;左耳下方肿胀较硬,压痛明显。神经系检查:右侧鼻唇沟变浅,右上唇麻痒,伸舌偏向左侧,活动失灵。头颅侧位及颅底X线片示枕骨大孔左侧、寰椎横突旁有一约2.1×1.5×1.0cm~3金属异物,右侧上颌窦积液(图略)。诊断:①颅 Male, 28 years old. On November 1, 1981, the bullet exploded with a homemade shotgun, injuring the right side of the face and bleeding more than that. More bleeding on the right nostril, left temporal pain, no nausea, vomiting and coma, the emergency room at 13:00 admission. Check: conscious; right side of the nose with “Y” -shaped wound, access to the maxillary sinus; posterior nasal septum and nasopharyngeal left wall wound, left soft palate submucosal congestion, soft palate limited mobility; swelling below the left ear Hard, tender and obvious. Nervous system examination: the right nasolabial fold shallow, itchy upper right lip, stretch tongue to the left, the activity fails. Craniofacial and skull base X-ray showed the left side of the foramen magnum, atlantoaxial next to a 2.1 × 1.5 × 1.0cm ~ 3 metal foreign body, right maxillary sinus fluid (Figure omitted). Diagnosis: ① skull