Unique Migration of a Dental Needle Into the Parapharyngeal Space: Successful Removal by an Intraoral Approach and Simulation for Tracking Visibility in X-ray Fluoroscopy

被引：9

作者：

Okumura, Yuri ^{[1
]}

Hidaka, Hiroshi ^{[1
]}

Seiji, Kazumasa ^{[2
]}

Nomura, Kazuhiro ^{[1
]}

Takata, Yusuke ^{[1
]}

Suzuki, Takahiro ^{[1
]}

Katori, Yukio ^{[1
]}

机构：

[1] Tohoku Univ, Dept Otolaryngol Head & Neck Surg, Grad Sch Med, Sendai, Miyagi 9808575, Japan

[2] Tohoku Univ, Dept Diagnost Radiol, Grad Sch Med, Sendai, Miyagi 9808575, Japan

来源：

ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY | 2015年 / 124卷 / 02期

关键词：

compensating filter; needle migration; parapharyngeal space; surgical microscope; X-ray fluoroscopy; FOREIGN-BODY; C-ARM; MANAGEMENT; ABSCESSES; BREAKAGE; DRAINAGE; NERVE;

D O I：

10.1177/0003489414547106

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Objectives: The first objective was to describe a novel case of migration of a broken dental needle into the parapharyngeal space. The second was to address the importance of simulation elucidating visualization of such a thin needle under X-ray fluoroscopy. Methods: Clinical case records (including computed tomography [CT] and surgical approaches) were reviewed, and a simulation experiment using a head phantom was conducted using the same settings applied intraoperatively. Results: A 36-year-old man was referred after failure to locate a broken 31-G dental needle. Computed tomography revealed migration of the needle into the parapharyngeal space. Intraoperative X-ray fluoroscopy failed to identify the needle, so a steel wire was applied as a reference during X-ray to locate the foreign body. The needle was successfully removed using an intraoral approach with tonsillectomy under surgical microscopy. The simulation showed that the dental needle was able to be identified only after applying an appropriate compensating filter, contrasting with the steel wire. Conclusion: Meticulous preoperative simulation regarding visual identification of dental needle foreign bodies is mandatory. Intraoperative radiography and an intraoral approach with tonsillectomy under surgical microscopy offer benefits for accessing the parapharyngeal space, specifically for cases medial to the great vessels.

引用

页码：162 / 167

页数：6