Predisposing factors, clinical presentation and outcome
of treatment of avulsive human bites on the face: a case series
analysis from Abuja, Nigeria
Reni Initari Mike-Ogiasa
Ademola Abayomi Olaitan
Oluseun Abidemi Aluko-Olokun
Received: 22 April 2014 /Accepted: 13 June 2014 / Published online: 25 July 2014
Springer-Verlag Berlin Heidelberg 2014
Background Human bite can be classified as occlusive or
non-occlusive. Occlusive bites are seldom reported to occur
outside the facial region. This study aims to analyze cases of
avulsive human bite and find which part of the face is the most
frequently involved in such cases. The findings may indicate
which part of the face is generally perceived as the most
critical in judging attractiveness.
Methods This retrospective study was carried out using
a data review of all consecutive avulsive facial human
bite cases seen in the maxillofacial surgery unit, Nation-
al Hospital Abuja, between February 2001 and January
2014. Uniform protocol of prophylactic oral antibiotic
and anti-tetanus cover was ensured throughout the study
Results Seventeen cases were included in this study. Amorous
jealousy was the cause of altercation in 15 (88.2 %) cases.
Twelve (70.6 %) cases involved the lip. There were eight
female and nine male victims. There were nine female and
eight male assailants.
Conclusions The lip is the most frequently affected region of
the face in avulsive human bite attacks in our environment.
This may be because it is considered the most important
anatomical region of the face on which judgment of attrac-
tiveness is based.
Level of evidence: Level IV, prognostic/risk study.
Human bite can be classified as occlusive or non-occlusive.
Occlusive bites are seldom reported to occur outside the facial
region . This region constitutes much less than 9 % of the
body by surface area, which the whole head accounts for. That
it is the most frequent target of such attack in spite of its
relatively small size must bear a reason.
In our environment, amorous or sexual jealousy is often
cited in the emergency room as the cause of interpersonal
altercation leading to avulsive human bite injury of the face.
The assailant probably seeks to damage or destroy part of the
victim’s face in order to gain relative advantage of attractive-
ness over the victim. Most of such injuries are solitary and
therefore must be expected by the assailant to cause the most
negative impact to the face of the victim while giving maxi-
mum satisfaction to the assailant. Such base behavior may
indicate that the face is the anatomical region assailants con-
sider the most threatening to their interest or most treasured by
the victim. This study aims to find which part of face is the
most at risk when a fight involves the active use of bite as a
weapon for inflicting avulsive injury. Such finding may reveal
which part of the face is the most critical in judging
B. Aluko-Olokun (*)
Department of Facial Surgery, National Hospital Abuja, Abuja,
R. I. Mike-Ogiasa
Department of Public Health and Primary Care, University of
Cambridge, Cambridge, UK
A. A. Olaitan
Department of Oral and Maxillofacial Surgery, Lagos State
University, Lagos, Nigeria
O. A. Aluko-Olokun
Department of Radiology, National Hospital Abuja, Abuja, Nigeria
Eur J Plast Surg (2014) 37:523–528