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A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management

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 an...

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Autores principales: Malkawi, Ziad, Alayeh, Alaa, Alshawa, Abedalaziz, Shaban, Ola, Al Saraireh, Omar, Malkawi, Hashem, Babkair, Hamzah, Abdouh, Ismail, Dar-Odeh, Najla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10572263/
https://www.ncbi.nlm.nih.gov/pubmed/37835792
http://dx.doi.org/10.3390/diagnostics13193050
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author Malkawi, Ziad
Alayeh, Alaa
Alshawa, Abedalaziz
Shaban, Ola
Al Saraireh, Omar
Malkawi, Hashem
Babkair, Hamzah
Abdouh, Ismail
Dar-Odeh, Najla
author_facet Malkawi, Ziad
Alayeh, Alaa
Alshawa, Abedalaziz
Shaban, Ola
Al Saraireh, Omar
Malkawi, Hashem
Babkair, Hamzah
Abdouh, Ismail
Dar-Odeh, Najla
author_sort Malkawi, Ziad
collection PubMed
description 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.
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spelling pubmed-105722632023-10-14 A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management Malkawi, Ziad Alayeh, Alaa Alshawa, Abedalaziz Shaban, Ola Al Saraireh, Omar Malkawi, Hashem Babkair, Hamzah Abdouh, Ismail Dar-Odeh, Najla Diagnostics (Basel) Interesting Images 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. MDPI 2023-09-25 /pmc/articles/PMC10572263/ /pubmed/37835792 http://dx.doi.org/10.3390/diagnostics13193050 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Interesting Images
Malkawi, Ziad
Alayeh, Alaa
Alshawa, Abedalaziz
Shaban, Ola
Al Saraireh, Omar
Malkawi, Hashem
Babkair, Hamzah
Abdouh, Ismail
Dar-Odeh, Najla
A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
title A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
title_full A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
title_fullStr A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
title_full_unstemmed A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
title_short A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
title_sort case of broken local anesthetic needle in the pterygomandibular space; diagnostic approaches and surgical management
topic Interesting Images
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10572263/
https://www.ncbi.nlm.nih.gov/pubmed/37835792
http://dx.doi.org/10.3390/diagnostics13193050
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