Karakida Kazunari, Takahashi Miho, Sakamoto Haruo, Nakanishi Yasuhiro, Tamura Masashi
Department of Oral and Maxillofacial Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan.
Tokai J Exp Clin Med. 2020 Sep 20;45(3):108-112.
A 33G, 12-mm needle broke and entered the soft tissue in a 60-year old man. Panoramic X-ray imaging and cone-beam computed tomography (CT), which we performed a few hours after the breakage, revealed the needle in the soft tissue of the lower right mandibular molar. We immediately made an incision in the buccal gingiva of the lower right mandibular molar under local anesthesia and attempted to remove the needle but could not locate it. Thereafter, we adopted a watch-and-wait approach, as the patient had no subjective symptoms. Nine months later, we confirmed via CT that the needle had migrated subcutaneously to the right side of the neck. Two months later, we identified its location using C-arm fluoroscopy and removed it under general anesthesia. This report is a rare case and we are the first to document the subcutaneous migration of a fractured needle.
一根33G、12毫米的针头折断并刺入了一名60岁男性的软组织。针头折断几小时后，我们进行了全景X线成像和锥形束计算机断层扫描（CT），结果显示针头位于右下颌磨牙的软组织中。我们立即在局部麻醉下于右下颌磨牙的颊侧牙龈处做了切口，试图取出针头，但未能找到。此后，由于患者没有主观症状，我们采取了观察等待的方法。九个月后，我们通过CT确认针头已皮下迁移至颈部右侧。两个月后，我们使用C型臂荧光透视确定了其位置，并在全身麻醉下将其取出。本报告是一例罕见病例，我们是首个记录折断针头皮下迁移情况的。
