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Ma DY, Zhang SM, Pang CY, Zhang WK, Wang BW. A serial case study of the combined use of intraoperative CT and surgical navigation system for the removal of small foreign bodies in the maxillofacial region. Chin J Traumatol 2024:S1008-1275(24)00077-4. [PMID: 39068132 DOI: 10.1016/j.cjtee.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/30/2024] [Accepted: 06/06/2024] [Indexed: 07/30/2024] Open
Abstract
PURPOSE The removal of small foreign bodies embedded within the deep soft tissues of the maxillofacial region is a complex and challenging task for maxillofacial surgeons. The purpose of this study was to explore the efficacy of the combination of intraoperative CT and surgical navigation for the removal of small foreign objects in the maxillofacial region. METHODS A serial case study was conducted involving all consecutive patients who underwent surgical removal of small foreign bodies in the maxillofacial region. The combination of intraoperative CT and a surgical navigation system was used at a single medical institution from January 2018 to December 2022. Comprehensive data, including patient demographics, characteristics of the foreign bodies, previous surgical interventions, duration of the surgical procedure, and removal success rate were collected for this study. Relevant data were recorded into Microsoft Excel sheet and analyzed using SPSS version 22.0. RESULTS Nine patients (6 males and 3 females) were included in this study, with an average age of 37 years. Each patient had previously undergone an unsuccessful removal attempt utilizing conventional surgical methods based on preoperative CT imaging or C-arm guidance at a local healthcare facility. Four patients also experienced unsuccessful attempts with preoperative CT image-based navigation systems. However, by employing the combined approach of intraoperative CT and surgical navigation, the foreign bodies were successfully removed in all 9 patients. The mean duration of the surgical procedure was 59 min, and the average size of the foreign bodies was approximately 26 mm³. Postoperative follow-up exceeding 6 months revealed no complications. CONCLUSION The combined use of a surgical navigation system and intraoperative CT represents a potent and effective strategy for the precise localization and subsequent removal of small foreign bodies from the soft tissue structures of the maxillofacial region. This integrative approach appears to increase the success rate of surgical interventions in such cases.
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Affiliation(s)
- Dong-Yang Ma
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, 730050, China; Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, 730000, China.
| | - Shu-Meng Zhang
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Chao-Yuan Pang
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, 730050, China
| | - Wen-Kai Zhang
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, 730050, China
| | - Bing-Wu Wang
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, 730050, China
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Zhang Z, Yang M, Zhang R. Radiographic grid for locating foreign bodies in maxillofacial emergency trauma. BMC Oral Health 2024; 24:46. [PMID: 38191426 PMCID: PMC10775646 DOI: 10.1186/s12903-023-03807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES The accurate localization of the foreign bodies (FBs) is essential. This work presents a new noninvasive technique for subcutaneous metallic FBs under a radiographic grid, a system that simplifies the localization of facial FBs removal using a grid with embedded reference points. METHODS This work designed a retrospective study to evaluate the effect of a radiographic grid on FBs removal surgery. All patients who met the inclusion criteria and attended the Hospital of Stomatology of China Medical University from January 2022 to June 2023 were enrolled and randomly divided into grid and non-grid groups. The assessment of facial swelling, the primary indicator, was conducted on days 2 and 7 post-surgery. The variables were analyzed using the Student t test and a repeated-measures general linear model. RESULTS The study sample consisted of 20 patients, with 14 males (70%) and 6 females (30%), who had an average age of 30.30 ± 5.38. The average time of operation was 1.85 ± 0.66 h (range 0.7 to 3.2). In the present cases in this report, of the 20 patients' FBs, 14 were metal, 5 were glass, and 1 was residual root. And the FBs were surgically removed with no postoperative complications. Through comparison, it was found that the degree of swelling on day 2 postoperatively was significantly different between the grid group and the non-grid group (P < 0.05). CONCLUSIONS This study demonstrates that a radiographic grid with mark points is a more efficient approach compared with traditional methods for FBs removal, and this surgical method is more accurate, fast and noninvasive.
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Affiliation(s)
- Ziqi Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Mingliang Yang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Ran Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China.
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3
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Alam M, Golkar M, Badkoobeh A, Baseri M. Jael's syndrome: Hemostatic management of an impacted knife in the facial site-A case report. Clin Case Rep 2023; 11:e8163. [PMID: 37965184 PMCID: PMC10641294 DOI: 10.1002/ccr3.8163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/16/2023] Open
Abstract
Key Clinical Message It is essential to take a specific multidisciplinary approach in penetrating maxillofacial traumas; securing the airway, completing the hemodynamic stabilization, and systemic evaluation and consideration regarding the beneficial therapeutic regime. Abstract Jael's syndrome is defined as a deliberate injury caused by a knife to the skull and facial area. This article describes the case of a young male patient with a penetrating knife on the left side of the face following an assault. Due to the high probability of injury to the descending palatine artery, it was decided to make a femoral pathway for catheter angiography in the operation room and have a standby vascular surgeon for selective embolization of the external carotid artery in case of severe bleeding. The treatment plan included removing the foreign body, exploring the wound, suturing, tetanus immunization, and prescribing antibiotics. There was no significant complication in the postoperative period. However, In the 6-month follow-up, the patient complained of weakness in the left upper lip and hypoesthesia in the pathway of the left infraorbital nerve. Jael's syndrome can be life-threatening, so there is a need for accurate initial management performed by a multidisciplinary team to raise the survival rate of these patients.
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Affiliation(s)
- Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of DentistryShahid Beheshti University of Medical SciencesTehranIran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of DentistryShahid Beheshti University of Medical SciencesTehranIran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of DentistryQom University of Medical SciencesQomIran
| | - Milad Baseri
- Department of Oral and Maxillofacial Surgery, School of DentistryShahid Beheshti University of Medical SciencesTehranIran
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4
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Kekre M, Chakravarty S, Agarwal R. Foreign Bodies in Ear, Nose, Throat and Maxillofacial Region: A Study on Their Clinical Profile and Complications. Indian J Otolaryngol Head Neck Surg 2022; 74:4483-4494. [PMID: 36742524 PMCID: PMC9895506 DOI: 10.1007/s12070-020-02233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023] Open
Abstract
The clinical picture and treatment options of foreign bodies in ENT vary widely depending on the site of involvement. Our study was a comprehensive review of both luminal and extraluminal foreign bodies in Otorhinolaryngology. A hospital based cross-sectional retrospective study was conducted to study the foreign bodies in ear, nose, throat and maxillofacial region in terms of demography, various modes of entry, site of lodgement, clinical features, treatment modalities and complications. While majority of the previous studies have focused on objects entering through natural orifices of ear, nose and throat, our study was a comprehensive review of both luminal and extraluminal foreign bodies in otorhinolaryngology. It was a retrospective study of four years duration on patients who presented with foreign bodies in OPD and emergency ward. Relevant data were tabulated and clinical and radiological documentation of interesting case scenarios have been depicted. The commonest age group affected was 0-10 years with 111 (58.52%) out of 190 cases. The most common site was aerodigestive tract ( 40%), followed by ears (31%), nose (26%) and maxillofacial region (3%). Insects, vegetable seeds and coins were the most common FBs in ear, nose and throat respectively. Foreign bodies have shown seasonal, geographic, socioeconomic and occupational variations in their distribution. Patient's age, type of foreign body, chance of migration to deeper tissue planes, failed unskilled removal attempts, delay in diagnosis and presence of comorbidities can complicate chances of removal.
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Affiliation(s)
- Meenakshi Kekre
- Department of ENT and Head Neck Surgery, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh India
- Chandulal Chandrakar Memorial Medical College, Bhilai, Chhattisgarh India
| | - Sharmistha Chakravarty
- Department of ENT and Head Neck Surgery, Raipur Institute of Medical Sciences, Raipur, Chhattisgarh India
| | - Rashi Agarwal
- Department of ENT and Head Neck Surgery, Chandulal Chandrakar Memorial Medical College, Bhilai, Chhattisgarh India
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Joshna EK, Poorna TA, Bobby J, Mohan S. Embedded Foreign Bodies in the Maxillofacial Region: Our Experience. Indian J Otolaryngol Head Neck Surg 2022; 74:4802-4806. [PMID: 36742923 PMCID: PMC9895343 DOI: 10.1007/s12070-022-03111-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/09/2022] [Indexed: 02/07/2023] Open
Abstract
Impacted Foreign Bodies (FB) within the maxillofacial region are often inadequately diagnosed during the initial examination. Proper evaluation and management are mandatory to avoid untoward consequences. We depict a series of five cases with impacted FBs, managed case-specifically, along with an algorithm for dealing FBs in the maxillofacial region.
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Affiliation(s)
- E. K. Joshna
- Department of Oral and Maxillofacial Surgery, Government Medical College, Kottayam, Kerala India
| | - T. Anish Poorna
- Department of Oral and Maxillofacial Surgery, Government Medical College, Kottayam, Kerala India
| | - John Bobby
- Department of Oral and Maxillofacial Surgery, Government Medical College, Kottayam, Kerala India
| | - S. Mohan
- Department of Oral and Maxillofacial Surgery, Government Medical College, Kottayam, Kerala India
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6
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Ma W, Wang LD, Liang Y, Li M. Application of a digital guide in the removal of foreign body from the maxillofacial region. Br J Oral Maxillofac Surg 2019; 57:708-709. [PMID: 31221446 DOI: 10.1016/j.bjoms.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
Affiliation(s)
- W Ma
- Department of Oral and Maxillofacial Surgery, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-tech Zone, Kunming, 650106, China.
| | - L D Wang
- Department of Oral and Maxillofacial Surgery, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-tech Zone, Kunming, 650106, China.
| | - Y Liang
- Department of Oral and Maxillofacial Surgery, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-tech Zone, Kunming, 650106, China.
| | - M Li
- Department of Oral and Maxillofacial Surgery, School of Stomatology Kunming Medical University, 1088 Middle Haiyuan Road, High-tech Zone, Kunming, 650106, China.
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Al-Ahmady HH, El Sayed M, Fereir A, Ekram A, Mousa K. Removal of large impacted foreign body from the base of the skull through submandibular access: A multidisciplinary approach. Int J Surg Case Rep 2018; 50:21-24. [PMID: 30071376 PMCID: PMC6080633 DOI: 10.1016/j.ijscr.2018.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/02/2018] [Accepted: 07/14/2018] [Indexed: 11/23/2022] Open
Abstract
Cut wounds in the face, should be repaired after proper investigations. Trismus following trauma should be managed seriously. Removal of a foreign body from the maxillofacial region should be managed with Multidiscplinary team approach.
Introduction This report describes the removal of a missed impacted large piece of a glass that reaches the infra-temporal region after a traumatic injury at the submandibular area. Case presentation A nine year-old patient presented with a limited mouth opening (0.5 cm). Initial examination showed a scar of an old trauma in the submandibular area two months prior to presentation. The radiographic study showed a large knife-shaped foreign body with its tip at the infra-temporal region, and its base at the submandibular region. Further multi-slice computed tomography with angiography was done that showed close proximity of the foreign body to the branches of the external carotid artery; maxillary, lingual and facial branches. The foreign body was removed via extra-oral approach through the old scar of the past injury under general anesthesia. Dissection, exposure of the external carotid artery and preparing it for emergency ligation, were done before extraction of the foreign body. The patient’s mouth opening increased to 2.5 cm without any complications. Conclusion Cut wounds in the face should not be repaired in the primary care without detailed history, systematic examination and proper investigations.
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Affiliation(s)
- Hatem H Al-Ahmady
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry (Girls), Al Azhar University, cairo, Egypt
| | - Mohamed El Sayed
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Banha University, Banha, Egypt
| | - Ahmed Fereir
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Future University, End of 90th St., Fifth Settlement, New Cairo, Cairo, Egypt.
| | - Amr Ekram
- Oral and Maxillofacial Radiology, Ekram Center for Oral Radiology and Computer Assisted Surgeries, Cairo, Egypt
| | - Kareem Mousa
- Department of Radio-Diagnosis, Faculty of Medicine, Cairo University, Cairo, Egypt
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8
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Voss JO, Thieme N, Doll C, Hartwig S, Adolphs N, Heiland M, Raguse JD. Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge. Craniomaxillofac Trauma Reconstr 2018; 11:172-182. [PMID: 30087746 DOI: 10.1055/s-0038-1642035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/29/2017] [Indexed: 10/17/2022] Open
Abstract
Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.
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Affiliation(s)
- Jan Oliver Voss
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Nadine Thieme
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universitaät zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Christian Doll
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Stefan Hartwig
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Nicolai Adolphs
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Jan-Dirk Raguse
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
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Khandelwal P, Dhupar V, Akkara F, Hajira N. Impacted Foreign Bodies in the Maxillofacial Region-A Series of Three Cases. J Cutan Aesthet Surg 2018; 11:237-240. [PMID: 30886480 PMCID: PMC6371724 DOI: 10.4103/jcas.jcas_114_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Penetrating injuries to the maxillofacial region are very common. Foreign bodies embedded deep in the maxillofacial region due to these injuries pose a challenge to an oral and maxillofacial surgeon. These objects may become a potent source of pain and infection. Early diagnosis of these foreign bodies can be achieved by the use of plain radiographs, ultrasonography, computed tomographic scans, and magnetic resonance imaging. Once diagnosed and located, these foreign bodies should be removed. Here, we report three such cases where early diagnosis of these foreign bodies embedded in the maxillofacial region lead to their early and successful removal without complications.
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Affiliation(s)
- Pulkit Khandelwal
- Department of Oral & Maxillofacial Surgery, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Vikas Dhupar
- Department Oral & Maxillofacial Surgery, Goa Dental College & Hospital, Goa, India
| | - Francis Akkara
- Department Oral & Maxillofacial Surgery, Goa Dental College & Hospital, Goa, India
| | - Neha Hajira
- SMBT Dental College & Hospital, Sangamner, Maharashtra, India
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10
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Javadrashid R, Golamian M, Shahrzad M, Hajalioghli P, Shahmorady Z, Fouladi DF, Sadrarhami S, Akhoundzadeh L. Visibility of Different Intraorbital Foreign Bodies Using Plain Radiography, Computed Tomography, Magnetic Resonance Imaging, and Cone-Beam Computed Tomography: An in Vitro Study. Can Assoc Radiol J 2017; 68:194-201. [DOI: 10.1016/j.carj.2015.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 11/25/2022] Open
Abstract
Purpose The study sought to compare the usefulness of 4 imaging modalities in visualizing various intraorbital foreign bodies (IOFBs) in different sizes. Methods Six different materials including metal, wood, plastic, stone, glass. and graphite were cut in cylindrical shapes in 4 sizes (dimensions: 0.5, 1, 2, and 3 mm) and placed intraorbitally in the extraocular space of fresh sheep's head. Four skilled radiologists rated the visibility of the objects individually using plain radiography, spiral computed tomography (CT), magnetic resonance imaging (MRI), and cone-beam computed tomography (CBCT) in accordance with a previously described grading system. Results Excluding wood, all embedded foreign bodies were best visualized in CT and CBCT images with almost equal accuracies. Wood could only be detected using MRI, and then only when fragments were more than 2 mm in size. There were 3 false-positive MRI reports, suggesting air bubbles as wood IOFBs. Conclusions Because of lower cost and using less radiation in comparison with conventional CT, CBCT can be used as the initial imaging technique in cases with suspected IOFBs. Optimal imaging technique for wood IOFBs is yet to be defined.
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Affiliation(s)
- Reza Javadrashid
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Golamian
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Parisa Hajalioghli
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Shahmorady
- Department of Oral Radiology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Daniel F. Fouladi
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shohreh Sadrarhami
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Akhoundzadeh
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
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11
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Minimally Invasive Firearm Projectile Removal With the Use of Image Intensifiers. J Craniofac Surg 2016; 27:1612-3. [PMID: 27607125 DOI: 10.1097/scs.0000000000002818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Penetrating Neck Injury Remnant Mimicking Chronic Cutaneous Neck Fistula. J Craniofac Surg 2016; 27:1615-6. [PMID: 27483092 DOI: 10.1097/scs.0000000000002876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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13
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Importance of Imaging Examinations to Planning the Removal of a Foreign Body From the Tongue. J Craniofac Surg 2016; 27:e223-5. [PMID: 26872277 DOI: 10.1097/scs.0000000000002398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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14
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Foreign Body Mimicking a Dental Implant Radiographically. J Craniofac Surg 2015; 26:e738-9. [PMID: 26594991 DOI: 10.1097/scs.0000000000002248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Foreign bodies are often encountered in the maxillofacial region and can present in several ways. They frequently occur as a result of accidents, explosions, and gunshot injuries or because of iatrogenic factors in therapeutic interventions in daily dental practice. This report describes an unusual case of a broken elevator blade mimicking a dental implant embedded in alveolar bone radiographically, within the maxillary palatal mucosa during a traumatic maxillary right first molar extraction.
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15
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Yolcu S. Ultrasonography for foreign bodies in the soft tissue. Am J Emerg Med 2015; 33:977-8. [DOI: 10.1016/j.ajem.2015.03.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 12/01/2022] Open
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16
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Javadrashid R, Fouladi DF, Golamian M, Hajalioghli P, Daghighi MH, Shahmorady Z, Niknejad MT. Visibility of different foreign bodies in the maxillofacial region using plain radiography, CT, MRI and ultrasonography: an in vitro study. Dentomaxillofac Radiol 2014; 44:20140229. [PMID: 25426703 DOI: 10.1259/dmfr.20140229] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To compare the usefulness of four imaging modalities in visualizing various foreign bodies of different sizes. METHODS Foreign bodies of four sizes (0.5, 1, 2 and 3 mm) including metal, tooth, wood, plastic, stone, glass and graphite were embedded in six fresh sheep heads on bone surface between the corpus mandible and muscle, and inside the tongue muscle. A human dry skull served as an air-filled space. Plain radiography, CT, MRI and ultrasonography were used, and four skilled radiologists rated the findings individually. RESULTS All embedded foreign bodies except wood were best visualized using CT. Wood could only be detected using ultrasonography, and then only when fragments were >0.5 mm in size. Plain radiography and CT were almost equally accurate in visualizing metal and graphite. MRI was the least useful imaging technique. CONCLUSIONS In cases with suspected foreign bodies in the maxillofacial region, CT seems to be the optimal initial imaging study. Wood, however, could only be detected using ultrasonography.
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Affiliation(s)
- R Javadrashid
- 1 Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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17
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Kaviani F, Javad Rashid R, Shahmoradi Z, Gholamian M. Detection of foreign bodies by spiral computed tomography and cone beam computed tomography in maxillofacial regions. J Dent Res Dent Clin Dent Prospects 2014; 8:166-71. [PMID: 25346836 PMCID: PMC4206759 DOI: 10.5681/joddd.2014.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 12/09/2013] [Indexed: 12/22/2022] Open
Abstract
Background and aims. The imaging techniques commonly used for foreign body detection include plain radiography, xeroradiography, computed tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasonography. The aim of the present study was to compare cone-beam computed tomography (CBCT) with conventional CT scan in determination of the exact location of a foreign body in the maxillofacial area in vitro. Materials and methods. In this descriptive study, seven different materials were selected as foreign bodies with dimensions of approximately 2 mm, 1 mm, and 0.5 mm. These materials consisted of metal, glass, wood, stone, plastic, graphite and tooth. These foreign bodies were placed in a sheep head between the corpus of the mandible and muscle, in the tongue and in an air space. One conventional CT scan and two CBCT scans were made on the models. Results. Tooth, metal, stone and glass foreign bodies were seen clearly on CT and CBCT scans made by NewTom at the smallest size in air. However, CBCT scan by NewTom was a more effective technique for visualization of foreign bodies in air compared to conventional CT. Foreign bodies measuring 0.5 mm made of metal, stone, glass, graphite and teeth were detected by all devices in muscle tissue and adjacent bone. Conclusion. According to the results, CBCT scans of NewTom and Planmeca are appropriate tools for detecting foreign bodies with relative high density in the maxillofacial area.
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Affiliation(s)
- Farzaneh Kaviani
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Javad Rashid
- Assistant Professor, Department of Radiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Shahmoradi
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoud Gholamian
- Post-graduate Student, Department of Radiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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18
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Treatment of unstable fractures of the zygomatic arch. J Craniofac Surg 2014; 25:1143-4. [PMID: 24769614 DOI: 10.1097/scs.0000000000000834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Removal of reconstruction plates after treatment of mandibular fractures. J Craniofac Surg 2013; 24:1864-5. [PMID: 24036807 DOI: 10.1097/scs.0b013e3182a305af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Dominguete PR, Matos BF, Meyer TN, Oliveira LR. Jael syndrome: removal of a knife blade impacted in the maxillofacial region under local anaesthesia. BMJ Case Rep 2013; 2013:bcr-2013-008839. [PMID: 23580680 DOI: 10.1136/bcr-2013-008839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The presence of retained foreign bodies in the maxillofacial region as a consequence of penetrating injuries from knives is poorly documented in the scientific literature. This manuscript reports the case of a 30-year-old Caucasian with a knife blade lodged in the maxillofacial skeleton. Following clinical and radiographic exams, it was determined that the object had penetrated through the left nostril and nasal septum, in the direction of the right maxillary sinus, and remained impacted without causing injury to important anatomical structures. After systemic assessment and determination of the exact location of the knife blade, the object was removed in an outpatient setting under local anaesthesia. This manuscript aims to report a rare case of a transfacial penetrating injury involving a knife blade that was removed in an outpatient setting while also discussing the proper conduct and treatment options for similar cases in the context of a brief literature review.
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