Self inflicted shotgun wound to the face. Barrel of the gun was under the chin and the blast traveled up and forward.
All structures below the orbital floors are disrupted. The mandible, maxilla, palate and zygomas are missing and the soft tissue is severely compromised as is the airway. The posterior 1/3 of the tongue was visible on laryngoscopy providing a guide for locating the trachea for intubation. The patient required significant and numerous plastic surgeries and was discharged home after some weeks.
No brain or large neck vessel involvement. Both eyes were intact and he retained his vision. His vocal cords and larynx were also intact and speech was regained. The jaw was reconstructed with bone graft, skin grafts and muscle flaps, as was the nose.
9/2/13 UPDATE: There have been many comments on this video to the effect that the patient should have been "allowed to die" especially because this was a suicide attempt. Some have called the health professionals derogatory names and characterized them as "cruel" and worse.
First, a general comment. All patients are given the same quality of care, the same "standard of care" regardless of the cause of their illness or injury. Health care professionals are not there to judge individuals and/or their lives and then provide care according to some bias. To suggest suicide attempt patients should not receive full appropriate medical treatment is absurd, thoughtless and not part of civilized society.
Specifically regarding this patient, he was awake and alert on arrival and breathing on his own. He was not, in fact, dying. He was not bleeding to death. There were no major blood vessels that were damaged. Without ANY treatment he would have lived for a number of days (3-5 likely) until he slowly and painfully died from either a massive infection, severe swelling and occlusion of the airway (suffocated) or of dehydration. He would have been conscious the entire time.
He received multiple re-constructive surgeries both before and after he returned home. He did not go on to attempt or commit suicide for the 2 years of follow up we have knowledge of.