Malkawi Ziad, Alayeh Alaa, Alshawa Abedalaziz, Shaban Ola, Al Saraireh Omar, Malkawi Hashem, Babkair Hamzah, Abdouh Ismail, Dar-Odeh Najla
School of Dentistry, The University of Jordan, Amman 11942, Jordan.
King Hussein Cancer Center, Amman 11941, Jordan.
Diagnostics (Basel). 2023 Sep 25;13(19):3050. doi: 10.3390/diagnostics13193050.
Needle fracture during dental local anesthetic injections is a rare but significant, potentially serious complication. Various approaches for the location and removal of broken needles have been described; however, there are several difficulties and concerns related to the potential complications and critical anatomic challenges peculiar to the head and neck region. In this case, we describe the diagnostic approaches utilized in locating a broken needle that migrated in the pterygomandibular space following gag reflex, and sudden head movement of a middle-aged male patient. A meticulous diagnostic approach was employed to locate the needle utilizing CBCT scan, CT scan with contrast, and C-arm X-ray machine. The needle was successfully retrieved using an angled hemostat inserted through an oral incision, guided by a C-arm X-ray machine and ENT endoscopic instruments. While careful planning could prevent many complications that may arise during oral surgical procedures, inadvertent events leading to serious complications should be addressed using the appropriate and timely diagnostic techniques pre-and intra-operatively.
牙科局部麻醉注射过程中的针头折断是一种罕见但严重的潜在严重并发症。已经描述了多种定位和取出折断针头的方法；然而，与头颈部区域特有的潜在并发症和关键解剖挑战相关存在一些困难和问题。在本病例中，我们描述了在一名中年男性患者出现咽反射和突然头部移动后，用于定位在翼下颌间隙移位的折断针头的诊断方法。采用了细致的诊断方法，利用锥形束计算机断层扫描（CBCT）、增强CT扫描和C形臂X射线机来定位针头。在C形臂X射线机和耳鼻喉科内窥镜器械的引导下，通过口腔切口插入有角度的止血钳成功取出了针头。虽然精心规划可以预防口腔外科手术期间可能出现的许多并发症，但对于导致严重并发症的意外事件，应在术前和术中使用适当及时的诊断技术加以处理。
