Rubio-Palau Josep, Escrigas-Cañameras Ferran, Valls-Ontañon Adaia, Malet-Contreras Albert, Becerra-Castro Maria Victoria, Muchart-López Jordi, Hinojosa-Bernal José
Maxillofacial Surgery Unit, Sant Joan de Déu Hospital (SJD), Passeig Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain.
Plastic, Reconstructive and Aesthetic Surgery Department, Hospital Clínic de Barcelona (HCB), Carrer Villarroel 170, 08011, Barcelona, Spain.
J Surg Case Rep. 2025 Sep 23;2025(9):rjaf662. doi: 10.1093/jscr/rjaf662. eCollection 2025 Sep.
Local anaesthesia and nerve block are common practices in dental therapy. Although they are associated with low rate of complications, local events such as needle fracture could entail life threatening consequences. We present a case of a needle fracture in a 4 year old girl who underwent a minor dental procedure. The needle migrated intracranially through the foramen ovale. She required a multidisciplinary management with a final neurosurgical intervention in order to remove it. In addition to an initial diagnostic computerized tomography (CT), it was of utmost importance to have access to an intraoperative imaging tools (preferably low radiation CT in paediatric population) to monitor the potential risk of needle migration. This report demonstrates that a broken needle may migrate intracranially, among other complications, underscoring the importance of managing these cases in a tertiary referral hospital with the appropriate equipment and specialists.
局部麻醉和神经阻滞是牙科治疗中的常见操作。尽管它们的并发症发生率较低，但诸如针头折断等局部事件可能会带来危及生命的后果。我们报告一例4岁女童在接受小型牙科手术时发生针头折断的病例。针头经卵圆孔向颅内迁移。她需要多学科管理，最终进行神经外科干预以取出针头。除了最初的诊断性计算机断层扫描（CT）外，能够使用术中成像工具（儿科人群最好使用低辐射CT）来监测针头迁移的潜在风险至关重要。本报告表明，断针可能会向颅内迁移，以及出现其他并发症，强调了在具备适当设备和专家的三级转诊医院处理这些病例的重要性。
