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一种罕见的手术并发症:滑落的磨牙嵌顿于声带及其麻醉处理

An unusual surgical complication: Slipped molar lodged in vocal cords and its anesthetic management.

作者信息

Begum Ameerunnisha, Ram Ramsesh Manohar, Prasad Monisha

机构信息

Department of Anesthesiology and Pain Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, India.

Department of Anesthesiology and Pain Medicine, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, India.

出版信息

J Oral Biol Craniofac Res. 2025 Jan-Feb;15(1):22-24. doi: 10.1016/j.jobcr.2024.11.006. Epub 2024 Nov 30.

Abstract

BACKGROUND

Extraction of wisdom tooth is one of the most common surgical interventions, as it is more prone for impaction. Due to the pain and anxiety associated with the procedure, it is common to do this procedure under conscious sedation. However unexpected events do occur during the procedure and one such complication along with the prompt management is discussed here.

CASE REPORT

This case report details an unusual occurrence of a third molar tooth slipping during dental extraction and becoming lodged at the base of the vocal cords. The patient, a 52-year-old man with a history of hypertension, underwent the procedure under conscious sedation. The case report highlights the importance of preparedness and multidisciplinary coordination in managing rare complications during dental procedures under conscious sedation. The accidental aspiration of a molar tooth into the airway required prompt and effective intervention, using dexmedetomidine for sedation, fibre-optic bronchoscopy for visualization, and a range of retrieval instruments. Using video-assisted laryngoscopy and fibre-optic laryngoscopy proved indispensable in locating and safely retrieving the foreign body without resorting to more invasive procedures.

CONCLUSION

This case highlights the importance of anaesthesiologist's role in emergency management and comprehensive preparedness in dental practice.

摘要

背景

智齿拔除是最常见的外科手术之一,因为智齿更易发生阻生。由于该手术会带来疼痛和焦虑,通常在清醒镇静下进行。然而,手术过程中确实会发生意外事件,本文将讨论其中一种并发症及其及时处理方法。

病例报告

本病例报告详细描述了在拔牙过程中一颗第三磨牙滑落并卡在声带底部这一罕见情况。该患者为一名52岁男性,有高血压病史,在清醒镇静下接受了手术。该病例报告强调了在清醒镇静下进行牙科手术时,应对罕见并发症做好准备并进行多学科协作的重要性。一颗磨牙意外吸入气道需要迅速有效的干预,使用右美托咪定进行镇静,纤维支气管镜进行可视化操作,并使用一系列取出器械。事实证明,使用视频辅助喉镜和纤维喉镜对于定位和安全取出异物而不采取更具侵入性的手术至关重要。

结论

本病例突出了麻醉医生在牙科实践中的应急管理和全面准备工作中的重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2829/11650281/408a4405bfc9/ga1.jpg

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