Gareth, I used to think I was the 0nly gimp that tried my best only to be a bullet pillow. I'm a quad with limited shoulder and bicep, no hands. I kinda know where your coming from, and I've got some ideas that i thought i might post. Probly going to be kinda lengthy but hopefully it's beneficial.
i use a kensington trackball (expert mouse) and if you can move your feet and toes good enough it might be worth it to try and use a foot for the pointer the other foot for a button (probly for walk forward) That frees up your mouth. Ill tell you what i use and let you decide. for my shoot button, i use a little contraption i made. imagine a see-saw, one end resting on my down arrow and the other end has a string attached to it, the string runs to a lil stick that i pull with my mouth. so pull -> string lifts one end of see-saw -> other end mashes down the down arrow -> magic happens
. This would allow you to do 3 things at once, look, move and fire.
other ideas, make the mouse buttons bigger somehow, cut out hard plastic and use double sided tape to stick them together.
if you want one more button, you can slide the keyboard back almost under you chin, then use double sided tape to attach something sturdy to the space bar, or key close to your chin where you can mash it with your chin, perhaps maybe aim down sights.
also have you thought about using something like a pencil to hold in your mouth and type?
if you have any questions just let me know, im full of ideas and I would do almost anything to help a brother out.