The eye in the neck: removal of a sewing needle from the posterior pharyngeal wall

Dental needle foreign body in the neck: a case report

Foreign body (FB) ingestion is commonly seen in the ear nose and throat (ENT) field, with different presentations and sequelae. FBs can arrest in the upper aerodigestive tract or continue further down into either the airway tract to the bronchus or the digestive tract to the intestines. The pathway of an FB depends on the size and shape of the FB and how sharp its edges are. Since the 20th century, the use of disposable stainless-steel needles in the oral cavity has proven to be an effective and safe method for performing various intraoral procedures like dental infiltration or a root canal wash. Complications from their use are rare. Generally, dental needle breakages are caused by patients biting the needle, incorrect injection techniques, or inadequate preventative measures. The sudden movement of a patient during a procedure is one of the most common causes of breakage. Occasionally, needles are swallowed during dental procedures such as a root canal. Here, we report a case of a patient that swallowed a broken needle during a dental procedure. A few days later, the patient presented with neck pain, swelling, and a FB sensation. When the patient presented, she claimed that her symptoms had onset after consuming a meal containing duck meat. Initially, the patient was diagnosed as having ingested a duck bone. However, intraoperatively, the FB was discovered to be an injection needle that had migrated from the throat to the neck.

Related factors of outcomes of pharyngeal foreign bodies in children

Objective:

This study aimed to identify factors related to outcomes of the pharyngeal foreign bodies in children and to improve the management protocol of this disease.

Methods:

The medical records of 131 children with pharyngeal foreign bodies hospitalized in the hospital were retrospectively reviewed.

Results:

Significant differences were observed between the two groups (dislodgement and removal group) with respect to location of pharyngeal foreign bodies and age, while sex, time of pharyngeal foreign bodies, and nature of pharyngeal foreign bodies had no significant differences. Moreover, results suggested that location of pharyngeal foreign bodies and nature of pharyngeal foreign bodies were risk factors correlated with complications.

Conclusion:

Pharyngeal foreign body in children has a high rate of dislodgement (>50%). Foreign bodies in the oropharynx were more likely to dislodge compared with the foreign bodies in the laryngopharynx. Younger children were more likely to dislodge compared with older children. Although the risk of complications was very low, attention needs to be paid to the potential risks: local infection, deep abscess, and migration of foreign bodies. Because the possibility of complications caused by bone fragments and foreign bodies in the laryngopharynx increase obviously, hence, it is suggested to remove these kinds of foreign bodies as soon as possible to prevent complications.

Retained dental needle migration across the skull base to the cochlea presenting as hearing loss

OBJECTIVES

Long-term retained foreign bodies in the human body have been reported across many specialties, but relatively few exist in the ENT literature.

PATIENTS

We present a case report of a patient with a broken dental needle fragment in the posterior oral cavity with subsequent migration to the cochlea over the course of 4 years, eventually leading to hearing loss. CT scan and middle ear exploration demonstrated a 4-cm metallic fragment abutting the base of the cochlea, immediately adjacent to the internal carotid artery.

INTERVENTIONS

The needle segment was removed through an endaural approach without complication.

RESULTS

Postoperatively, the patient had improvements in PTA and speech discrimination, as well as the resolution of chronic otalgia and jaw pain. Imaging, audiologic results, and surgical details and pictures are presented herein.

CONCLUSION

To our knowledge, based on a thorough PubMed and Google Scholar search, there are no reports of such a foreign body migration from the oral cavity to the skull base.