Journal of Dental Anesthesia and Pain Medicine

  • 제22권4호
  • /
  • Pages.315-321
  • /
  • 2022
  • /
  • 2383-9309(pISSN)
  • /
  • 2383-9317(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
권호 표지
DOI QR코드

DOI QR Code

Fractured needle as an unusual complication of the lingual nerve block: a case report

  • Erdil, Aras (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Usak University) ;
  • Demirsoy, Mustafa Sami (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sakarya University) ;
  • Colak, Sefa (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpasa University)
  • 투고 : 2022.03.09
  • 심사 : 2022.07.05
  • 발행 : 2022.08.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Although rare, hypodermic needle fractures can occur in the maxillofacial region. In cases of fracture, urgent intervention is required to prevent further complications. We present the case of a 37-year-old female patient with a fractured needle in the left sublingual fossa during a lingual nerve block 6 months before referral. The fragment of a 30-gauge needle was located using cone-beam computed tomography and retrieved under local anesthesia with blunt dissection. The patient recovered uneventfully, except for predictable postoperative inflammatory complications, which resolved within 2 weeks. Precautions should be implemented to prevent needle fractures, which are usually preventable. However, if the retrieval is unsuccessful, the patient should be referred to a well-equipped surgical unit without delay.

키워드

과제정보

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

참고문헌

  1. Pogrel MA. Broken local anesthetic needles: a case series of 16 patients, with recommendations. J Am Dent Assoc 2009; 140: 1517-22. https://doi.org/10.14219/jada.archive.2009.0103
  2. Monteiro MAO, Antunes ANDG, Basting RT. Physical, chemical, mechanical, and micromorphological characterization of dental needles. J Dent Anesth Pain Med 2021; 21: 139-53. https://doi.org/10.17245/jdapm.2021.21.2.139
  3. Augello M, von Jackowski J, Gratz KW, Jacobsen C. Needle breakage during local anesthesia in the oral cavity-a retrospective of the last 50 years with guidelines for treatment and prevention. Clin Oral Investig 2011; 15: 3-8. https://doi.org/10.1007/s00784-010-0442-6
  4. Acham S, Truschnegg A, Rugani P, Kirnbauer B, Reinbacher KE, Zemann W, et al. Needle fracture as a complication of dental local anesthesia: recommendations for prevention and a comprehensive treatment algorithm based on literature from the past four decades. Clin Oral Investig 2019; 23: 1109-19. https://doi.org/10.1007/s00784-018-2525-8
  5. Queiroz SB, Lima VN, Amorim PH, Magro-Filho O, Amorim RF. Retrieval of a broken dental needle close to the facial artery after cervical migration. J Craniofac Surg 2016; 27: e338-40. https://doi.org/10.1097/SCS.0000000000002507
  6. Rahman N, Clarke M, Stassen LF. Case report: management of broken dental needles in practice. J Ir Dent Assoc 2013; 59: 241-5.
  7. Sahin B, Yildirimturk S, Sirin Y, Basaran B. Displacement of a broken dental injection needle into the perivertebral space. J Craniofac Surg 2017; 28: e474-7. https://doi.org/10.1097/SCS.0000000000003781
  8. Karakida K, Takahashi M, Sakamoto H, Nakanishi Y, Tamura M. Subcutaneous migration of a broken dental needle from the mandibular gingiva to the neck: a case report. Tokai J Exp Clin Med 2020; 45: 108-12.
  9. Marinheiro BH, Araujo RTE, Sverzut TFV, Trivellato AE, Sverzut CE. Migration and surgical retrieval of a broken dental needle: a literature review and case report. Gen Dent 2019; 67: 34-7.
  10. Sandre LB, de Paula e Silva E, Izidro AER, Neto WMP, da Costa Moraes CA, da Rosa ELS. Observational and descriptive analysis of broken dental needles: a case series. Oral Maxillofac Surg 2022. available from doi: 10.1007/s10006-022-01078-7.
  11. Chen KJ, Lo WF, Chen I, Chen MYC. Clinical application of a surgical navigation system for the retrieval of fractured dental needles. Br J Oral Maxillofac Surg 2021; 59: 256-7. https://doi.org/10.1016/j.bjoms.2020.12.002
  12. Archer WH, Mangie AS, Irby WB. Removal of a broken mandibular needle using a modified Kazanjian guide; report of a case. Oral Surg Oral Med Oral Pathol 1952; 5: 609-14. https://doi.org/10.1016/0030-4220(52)90247-8
  13. Kennett S, Curran JB, Jenkins GR. Management of a broken hypodermic needle: report of a case. Anesth Prog 1973; 20: 48-50.
  14. Zeltser R, Cohen C, Casap N. The implications of a broken needle in the pterygomandibular space: clinical guidelines for prevention and retrieval. Pediatr Dent 2002; 24: 153-6.
  15. McDonogh T. An unusual case of trismus and dysphagia. Br Dent J 1996; 180: 465-6. https://doi.org/10.1038/sj.bdj.4809128
  16. Okumura Y, Hidaka H, Seiji K, Nomura K, Takata Y, Suzuki T, et al. 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. Ann Otol Rhinol Laryngol 2015; 124: 162-7. https://doi.org/10.1177/0003489414547106
  17. Schorn L, Sproll C, Depprich R, Kubler NR, Rana M, Singh DD, et al. Navigated recovery of fractured dental injection needles: case report and suggestions for management during pandemic crises. Case Rep Dent 2021; 2021: 8820381.
  18. Lehmann AE, Scangas GA, Jafari A, Metson R. Endoscopic transoral image-guided retrieval of infratemporal fossa foreign bodies. OTO Open 2020; 4: 4-7.
  19. Lukas D, Jan M, Constantinus P, Paul L. Fractured needle removal with a 3-dimensionally printed surgical guide: a case report and literature review. J Oral Maxillofac Surg 2021; 79: 1019-24. https://doi.org/10.1016/j.joms.2020.11.002
  20. Kudo M. Initial injection pressure for dental local anesthesia: effects on pain and anxiety. Anesth Prog 2005; 52: 95-101. https://doi.org/10.2344/0003-3006(2005)52[95:IIPFDL]2.0.CO;2
  21. Pietruszka JF, Hoffman D, McGivern BE Jr. A broken dental needle and its surgical removal: a case report. N Y State Dent J 1986; 52: 28-31.