Felisati Giovanni, Saibene Alberto Maria, Di Pasquale Daniele, Borloni Roberto
Department of Otolaryngology, San Paolo Hospital, University of Milan, Milan, Italy.
BMJ Case Rep. 2012 Nov 28;2012:bcr2012007373. doi: 10.1136/bcr-2012-007373.
A 62-year-old man came to our attention after an operation in a small dental outpatient clinic where only a single dentist was working. The man was showing complications after insertion of a dental implant in the anterior segments of the mandible. Bleeding led to a slow swelling of the neck with airway obstruction. Only an immediate intervention by a mobile emergency unit and prompt tracheal intubation avoided death by asphyxia. The patient was then transferred to our hospital. We inspected the patient and we performed a CT scan that showed complete airway obstruction. First, we performed a tracheotomy in order to ensure the airway patency and then we identified the source of bleeding: the mylohyoid artery placed anomalously close to the mandible. After clamping and tying the artery, the bleeding resolved. One day after the procedure, the tracheotomy was closed; the patient was discharged after 3 days.
一名62岁男性在一家小型牙科门诊接受手术后引起了我们的注意，该门诊只有一名牙医坐诊。该男子在下颌前部植入牙种植体后出现并发症。出血导致颈部逐渐肿胀并伴有气道阻塞。仅通过移动急救单元的立即干预和及时气管插管才避免了窒息死亡。随后患者被转至我院。我们对患者进行了检查，并进行了CT扫描，结果显示气道完全阻塞。首先，我们进行了气管切开术以确保气道通畅，然后确定了出血源：下颌舌骨肌动脉位置异常，距离下颌骨过近。夹住并结扎该动脉后，出血停止。术后一天，气管切开伤口愈合；患者在3天后出院。
