title: Retrieval of a Broken Dental Needle Close to the Facial Artery After Cervical Migration.
abstract: Use of imaging tools like digital C-arm, tridimensional tomography, and navigational surgery has proven its value to the surgical removal of broken needles. A 32-year-old patient was referred for evaluation of a fractured needle during inferior alveolar nerve block attempt few days before. The patient complained of a pricking sensation at the injured area while moving the neck. A contrasted computed tomography was performed for further evaluation of the needle toward the vascular network of the neck, showing a close location by the left facial artery, parallel to the styloid process of the temporal bone. The needle was then released from the underlying tissues and retrieved. Although considered a rare intercurrence, there are still reports of breaking needles during dental anesthesia. Such reports are almost always related to inferior alveolar nerve blocks, associated with the use of short, thin needles, and after multiple bending movements before the insertion of the needle in the tissues. Accurate image examinations such as contrasted computed tomography are of great importance for planning the surgical removal, especially in patients of migration next to important vessels of the neck.
authors.affiliation: *School of Post-graduate Quixadaense (EQUIP), Quixadá †Department of Surgery and Integrated Clinic, Aracatuba Dental School, São Paulo State Univ Estadual Paulista "Julio de Mesquita Filho"-UNESP, Aracatuba ‡Faculty of Medicine, University Brasília-UnB, Brasília, Brazil.
authors.forename: Sormani Bento Fernandes de
authors.initials: SB
authors.lastname: Queiroz
authors.forename: Valthierre Nunes de
authors.initials: VN
authors.lastname: Lima
authors.forename: Pedro Henrique Gonçalves Holanda
authors.initials: PH
authors.lastname: Amorim
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Magro-Filho
authors.forename: Rivadávio Fernandes Batista
authors.initials: RF
authors.lastname: Amorim
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000295:instrumentation*; D001158:Arteries / Q000000981:diagnostic imaging; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008340:Mandibular Nerve / Q000000981:diagnostic imaging* / Q000187:drug effects*; D061330:Multidetector Computed Tomography; D009333:Neck / Q000098:blood supply*; D009339:Needles; D009407:Nerve Block / Q000295:instrumentation*; D014963:X-Ray Intensifying Screens