[Interventional multidimodal hybrid unit: from pre-operative planning to immediate post-operative control]

Retrieving a displaced third molar from the infratemporal fossa: case report of a minimally invasive procedure

Background

The appropriate management of postoperative complication of wisdom teeth removal is of utmost importance as it can result in legal procedures.

The accidental displacement of a maxillary third molar in the infratemporal fossa (ITF), is a rare complication that can occur even with experienced surgeons.

The numerous retrieval techniques reported are invasive and provide an unpredictable access.

Our aim was to achieve the safe and swift retrieval of the tooth displaced to an area of such complex anatomy.

Case presentation

We describe the case of a 17-year-old female patient whose right upper third molar was accidentally pushed upward to the ITF and became unreachable.

Retrieval based on interventional radiology using the CT-guided placement of a bone trocar above the displaced tooth was successfully performed. The postoperative course was uneventful.

Conclusions

CT scan assisted interventional radiology provides both, real-time assessment of the tooth position through image refreshment, and steady stabilization of the displaced tooth. Therefore, it allows a safe and non-traumatic retrieval with a time-efficient procedure achieved through a minimally-invasive approach with inconspicuous scaring. We believe that such a procedure is an interesting treatment option for optimal outpatient care.

To our knowledge, no such case has been previously described.

Electronic supplementary material

The online version of this article (10.1186/s12903-019-0852-z) contains supplementary material, which is available to authorized users.

Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to --image-guided video-assisted thoracoscopic surgery

The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases.

[Zygomatic bone repositioning osteotomies]

INTRODUCTION

The main morphological sequels of zygomatic bone fractures are lack of zygomatic projection and enopthalmia. They may be corrected by zygomatic osteotomy which is a difficult operation because of modified anatomic landmarks. Onlay bone or alloplastic grafts are preferred.

TECHNICAL NOTE

Zygomatic osteotomies are performed through three surgical approaches: superior palpebral, sub-ciliary, and upper vestibular, followed by repositioning with osteosynthesis micro-plates. They allow reconstruction with an adequate projection in three dimensions. Surgery is usually associated with a bone graft of the orbital floor.

DISCUSSION

Zygomatic osteotomy is a simple, reproducible technique, but it requires a good bone exposure. The esthetic results are satisfactory with an uneventful outcome. This surgical procedure is a good alternative to isolated techniques of autologous bone grafting or alloplastic material reconstruction which have sometimes disappointing and short lasting results due to graft resorption.