Terada Kazuhiro, Yamagata Kenji, Uchida Fumihiko, Fukuzawa Satoshi, Ishibashi-Kanno Naomi, Bukawa Hiroki
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Oral and Maxillofacial Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Case Rep Dent. 2022 Aug 17;2022:9626612. doi: 10.1155/2022/9626612. eCollection 2022.
The incidence of needle breakage is estimated to be 0.000007%, and most needle breaks occur during inferior alveolar nerve block (IANB) administration and are localized to the pterygomandibular space. Although immediate surgical intervention is recommended for the removal of the fracture needles, intraoperative localization of a broken injection needle fragment can be challenging. Here, we present the case of a 36-year-old woman who underwent dental extraction of the left lower wisdom tooth under local anesthesia at a private office. At that time, a disposable 33G needle was broken and accidentally inserted into the pterygomandibular space during IANB. A broken injection needle was presented at the base of the left coronoid process of the mandible on computed tomography (CT). We successfully removed the broken injection needle using fluoroscopy and assisted endoscopy under general anesthesia.
断针的发生率估计为0.000007%，大多数断针发生在下牙槽神经阻滞（IANB）注射过程中，且局限于翼下颌间隙。尽管建议立即进行手术干预以取出折断的针头，但术中定位折断的注射针碎片可能具有挑战性。在此，我们报告一例36岁女性的病例，该患者在一家私人诊所接受局部麻醉下的左下智齿拔除术。当时，一根一次性33G针头折断，并在IANB注射过程中意外插入翼下颌间隙。计算机断层扫描（CT）显示折断的注射针位于下颌骨左冠突基部。我们在全身麻醉下通过荧光透视和辅助内镜成功取出了折断的注射针。
