Holmes Pierre-John, Miller Jason R, Gutta Rajesh, Louis Patrick J
Oral & Maxillofacial Surgery, University of Alabama, Birmingham, Ala, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Nov;100(5):614-8. doi: 10.1016/j.tripleo.2005.02.072. Epub 2005 Sep 21.
Foreign bodies are frequently introduced into the tissues of the head and neck by various mechanisms, and oral and maxillofacial surgeons are often called upon to retrieve these embedded objects. Retrieval may be quite challenging depending on many factors such as the size of the object, the location, and the surrounding anatomical structures. Preoperative imaging is very important in deciding upon the surgical approach. Computerized tomography is considered the gold standard for detection of foreign bodies because of the ability to localize an object in multiple planes and the creation of a 3-dimensional image. Difficulty arises when looking for a small object in an area with multiple important anatomical structures, such as the infratemporal fossa or the neck. Surgery can become tedious secondary to the risk of postoperative morbidity with injury to various anatomical structures. Foreign bodies in the head and neck are often difficult to manage even when a plan has been formulated from static preoperative images. Intraoperative feedback or guidance, especially when navigating through troublesome locations, can be extremely useful. In this paper, we report 2 cases and discuss the various modalities used for intraoperative imaging as a guide for surgical retrieval of foreign bodies.
异物常通过各种机制进入头颈部组织，口腔颌面外科医生经常被要求取出这些嵌入的物体。根据许多因素，如物体的大小、位置和周围的解剖结构，取出异物可能极具挑战性。术前影像学检查对于决定手术方式非常重要。计算机断层扫描因其能够在多个平面定位物体并创建三维图像，被认为是检测异物的金标准。在有多个重要解剖结构的区域，如颞下窝或颈部，寻找小物体时会出现困难。由于存在损伤各种解剖结构导致术后发病的风险，手术可能会变得繁琐。即使根据术前静态图像制定了计划，头颈部的异物通常也难以处理。术中反馈或引导，尤其是在穿过棘手部位时，可能非常有用。在本文中，我们报告了2例病例，并讨论了用于术中成像以指导异物手术取出的各种方式。
