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局部牙科麻醉和牙源性感染相关眼部并发症的病因及病理生理途径:一项系统综述

Etiology and Pathophysiological Pathways of Ocular Complications Associated with Local Dental Anesthesia and Odontogenic Infections: A Systematic Review.

作者信息

Joshi Ajit, Jain Anuj, Chimote Monica Mahajan

机构信息

Department of Dentistry, Government Medical College, Chandrapur, Maharashtra India.

Department of Oral and Maxillofacial Surgery, Dr. H.S.R.S.M. Dental College and Hospital, Hingoli, Maharashtra India.

出版信息

J Maxillofac Oral Surg. 2022 Jun;21(2):648-667. doi: 10.1007/s12663-022-01715-4. Epub 2022 Apr 16.

Abstract

BACKGROUND

Ocular complications during or after dental extraction have been reported in the literature. These complications were either due to infiltration of local anesthetic solution or due to spread of odontogenic infection extending to the ocular region. The purpose of the present study is to outline the pathophysiological pathway of such ocular complications pertaining to dental procedures due to infiltration/local anesthesia block or spread of odontogenic infection.

METHODOLOGY

An exhaustive literature search was conducted in October 2020 on various online research databases to identify various etiological factors causing ocular complications during dental procedures or followed by odontogenic infections. The findings of all the articles recruited for the review were recorded and analyzed.

RESULTS

The search protocol revealed a total of 897 articles related to the study where only 208 relevant articles were recruited for detailed evaluation, which led to the exclusion of 123 articles and a total of 85 articles were included in the study. Out of the total 113 cases in 85 articles, 92 cases (81.42%) showed complications associated with the use of local anesthetic agent and 21 cases (18.58%) exhibited ocular complications due to spread of infections. Most common ocular complications reported were diplopia, followed by ptosis and ophthalmoplegia.

CONCLUSION

Dental anesthesia can cause a reversible or irreversible ophthalmic complication, while the infectious afflictions of the orbit still remain a challenge to the practicing maxillofacial surgeon.

摘要

背景

文献中已报道过拔牙过程中或拔牙后出现的眼部并发症。这些并发症要么是由于局部麻醉溶液的浸润,要么是由于牙源性感染扩散至眼部区域所致。本研究的目的是概述因浸润/局部麻醉阻滞或牙源性感染扩散而导致的与牙科手术相关的此类眼部并发症的病理生理途径。

方法

2020年10月在各种在线研究数据库中进行了详尽的文献检索,以确定导致牙科手术期间或牙源性感染后出现眼部并发症的各种病因。记录并分析了纳入综述的所有文章的研究结果。

结果

检索方案共检索到897篇与该研究相关的文章,其中仅208篇相关文章被纳入详细评估,导致排除123篇文章,最终共有85篇文章纳入研究。在85篇文章中的113例病例中,92例(81.42%)显示与使用局部麻醉剂相关的并发症,21例(18.58%)因感染扩散出现眼部并发症。报告的最常见眼部并发症是复视,其次是上睑下垂和眼肌麻痹。

结论

牙科麻醉可引起可逆或不可逆的眼科并发症,而眼眶的感染性疾病对执业颌面外科医生来说仍然是一个挑战。

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本文引用的文献

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Temporary Blindness after Inferior Alveolar Nerve Block.下牙槽神经阻滞麻醉后暂时性失明
J Clin Diagn Res. 2017 Mar;11(3):ZD24-ZD25. doi: 10.7860/JCDR/2017/24184.9601. Epub 2017 Mar 1.
5
Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Mar;121(3):e39-50. doi: 10.1016/j.oooo.2015.10.023. Epub 2015 Nov 10.
6
Difficulty in closing eyelid after local upper dental infiltration anaesthesia with articaine: case report.
Br J Oral Maxillofac Surg. 2016 Jul;54(6):713-4. doi: 10.1016/j.bjoms.2015.09.020. Epub 2015 Oct 21.
8
Endophthalmitis after tooth extraction in a patient with previous perforating eye injury.
Pan Afr Med J. 2015 Jan 27;20:72. doi: 10.11604/pamj.2015.20.72.6080. eCollection 2015.
10
Branch Retinal Artery Occlusion following Dental Extraction.拔牙后视网膜分支动脉阻塞
Case Rep Ophthalmol Med. 2014;2014:202834. doi: 10.1155/2014/202834. Epub 2014 Dec 16.

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