title: How the simplest dental implant procedure can trigger an extremely serious complication.
abstract: A 62-year-old man came to our attention after an operation in a small dental outpatient clinic where only a single dentist was working. The man was showing complications after insertion of a dental implant in the anterior segments of the mandible. Bleeding led to a slow swelling of the neck with airway obstruction. Only an immediate intervention by a mobile emergency unit and prompt tracheal intubation avoided death by asphyxia. The patient was then transferred to our hospital. We inspected the patient and we performed a CT scan that showed complete airway obstruction. First, we performed a tracheotomy in order to ensure the airway patency and then we identified the source of bleeding: the mylohyoid artery placed anomalously close to the mandible. After clamping and tying the artery, the bleeding resolved. One day after the procedure, the tracheotomy was closed; the patient was discharged after 3 days.
authors.affiliation: Department of Otolaryngology, San Paolo Hospital, University of Milan, Milan, Italy. giovanni.felisati@gmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Felisati
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Saibene
authors.forename: Daniele
authors.initials: D
authors.lastname: Di Pasquale
authors.forename: Roberto
authors.initials: R
authors.lastname: Borloni
mesh_terms: D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D003757:Dental Implantation / Q000009:adverse effects*; D004322:Drainage; D004487:Edema / Q000209:etiology; D006406:Hematoma / Q000150:complications* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000150:complications* / Q000209:etiology / Q000601:surgery; D014140:Tracheotomy