Introduction:- The incidence of gunshot wounds to the face have been on a rise but still are rare compared to firearm injuries to other regions of the body. Such injuries can be devastating due to the presence of vital structures in the vicinity. We describe a rare case of retained bullet in the infratemporal fossa which presented with delayed onset facial palsy and was meticulously removed with the help of 0 degree endoscope. Case Report: - A male patient aged 36 years reported to the emergency department of KEM hospital for management of gunshot injury to left side of face. The trauma was as a result of homicidal gunshot injury. However, 6 days following the episode the patient developed left sided facial palsy. Computerised tomography of the face revealed presence of metallic foreign body impacted in the infratemporal fossa with associated fracture of the mandibular condyle and temporal bone fracture. The bullet was located in a critical position only within 5mm of carotid artery. . Upper part of the condylar process along with the condylar head was removed for better access. Hopkins O degree endoscope was used to further trace the entry wound down up to the infratemporal fossa. Conclusion: - The successful outcome depends on careful planning and multidisciplinary team approach. In our case, we would also like to highlight that the use of endoscope was extremely helpful and helped us to avoid the morbidity associated with external approach.
