Hyenas are effective hunters and will consider humans as potential prey if the need and opportunity arise. This study describes the circumstances of hyena attacks, the patterns of injuries sustained, and reconstruction in a resource-poor setting. As part of a charitable surgical mission to Ethiopia in 2012, 45 patients with facial deformities were reviewed, of whom four were victims of hyena attacks. A semi-structured interview was performed to ascertain the circumstances of the attack and the subsequent consequences. The age of the victims at the time of attack varied from 5 to 50 years. The attacks occurred when the victims were alone and vulnerable and took place in outdoor open spaces, during the evening or at night. The initial lunge was made to the facial area; if the jaws closed on the facial bones they were crushed, but in all cases the soft tissues were grasped and torn from the underlying bone. Reconstruction was dictated by the extent of soft tissue loss but could normally be obtained by use of local or regional flaps. Hyenas have been shown to attack humans in a predictable way and cause injuries that typically involve the soft tissues of the face.
Spotted hyenas ( Crocuta crocuta ), hereafter referred to simply as hyenas, are the most common carnivore in Sub-Saharan Africa, with substantial numbers found especially in eastern areas of the continent. Hyenas have adapted to survive in a range of habitats including deserts, woodlands, and mountainous areas, but tend to congregate in greatest abundance near game reserves and areas of human settlement. The two other extant species of the hyena family are the brown hyena ( Hyaena brunnea ), which is found in South Africa, and the striped hyena ( Hyaena hyaena ), which is found in northern Africa and parts of Asia.
Hyenas are large (45–80 kg) predators, distinguished by exceptionally enlarged premolars, robust skulls, and heavily muscled jaws (see Fig. 1 ). Though historically regarded as pure scavengers, hyenas are in fact effective hunters, with observation studies showing active hunting to account for 60–90% of their food intake. Hyenas require 4 kg of meat per day to maintain their condition, but compared to carnivores of a similar size, they do not exhibit a significant preference for prey selection and have been observed eating species ranging from fish to buffalo. Hyenas will adapt their killing method depending on the size of prey, with a disembowelling technique used for larger animals and the tearing away of chunks of flesh from the head and neck region in small to medium sized animals.