Accidental Insertion of a Broken Needle into the Pterygoid Mandibular Space during Inferior Alveolar Nerve Block: A Case Report

The incidence of needle breakage is estimated to be 0.000007%, and most needle breaks occur during inferior alveolar nerve block (IANB) administration and are localized to the pterygomandibular space. Although immediate surgical intervention is recommended for the removal of the fracture needles, in...

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Bibliographic Details
Published in:Case reports in dentistry 2022-08, Vol.2022, p.1-4
Main Authors: Terada, Kazuhiro, Yamagata, Kenji, Uchida, Fumihiko, Fukuzawa, Satoshi, Ishibashi-Kanno, Naomi, Bukawa, Hiroki
Format: Article
Language:English
Subjects:
Anesthesia
Case Report
Case reports
Computed tomography
Endoscopy
Fluoroscopy
Fractures
Injection
Literature reviews
Local anesthesia
Localization
Mandible
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Summary:The incidence of needle breakage is estimated to be 0.000007%, and most needle breaks occur during inferior alveolar nerve block (IANB) administration and are localized to the pterygomandibular space. Although immediate surgical intervention is recommended for the removal of the fracture needles, intraoperative localization of a broken injection needle fragment can be challenging. Here, we present the case of a 36-year-old woman who underwent dental extraction of the left lower wisdom tooth under local anesthesia at a private office. At that time, a disposable 33G needle was broken and accidentally inserted into the pterygomandibular space during IANB. A broken injection needle was presented at the base of the left coronoid process of the mandible on computed tomography (CT). We successfully removed the broken injection needle using fluoroscopy and assisted endoscopy under general anesthesia.
ISSN:2090-6447
2090-6455
DOI:10.1155/2022/9626612