True diagnosis and treatment of broken glass inoculated into mandible: a case report

Year 2014, , 95 - 8, 21.05.2014

Celal Bahadır Giray Mustafa Yiğit Saysel Bahadır Kan Özde Sezgin Seçil Güney

https://doi.org/10.17214/aot.71201

Abstract

INTRODUCTION: Foreign materials can be inoculated into the body after traumatic injuries. If proper diagnosis methods are not used, their detection may be difficult. In these cases, foreign objects may be left in the body, and malpractice occurs.

CASE REPORT: In clinical and radiographical examinations of an 11-year-old patient with a history of traffic accident and persisting pain in the mandible, foreign objects were detected inoculated in the mandible. After the accident, the patient had referred to a health center, received a first intervention there and was discharged from the center; but with the foreign object remaining unnoticed. Due to persisting pain in the mandible, the patient was then referred to our clinic with a diagnosis of mandible fracture. In the related area, radiopaque formations distinguished hardly even by using advanced imaging methods were diagnosed, and surgically removed.

CONCLUSION: Surgically-removed foreign materials were car glass. In this case report it has been presented and discussed that foreign materials (i.e. car glass in this case) can be confused with mandible fracture.

Keywords

Bone, Foreign Bodies, Mandible, Panoramic Radiography, Tomography, Traffic Accidents

Alt çeneye inokule olan cam parçalarının doğru tanı ve tedavisi: bir olgu bildirimi

Abstract

TANITIM: Travmatik yaralanmalar sonrasında vücuda yabancı cisimler girebilir. Bu yabancı cisimlerin doğru tanı yöntemleri kullanılmazsa saptanmaları zordur. Bu nedenle yabancı cisimler vücut içinde bırakılabilir veya yanlış tedavilerin uygulanmasına yol açabilir.

OLGU BİLDİRİMİ: Trafik kazası geçirmiş ve alt çenesinde ağrı şikayeti ile kliniğe başvuran 11 yaşındaki hastanın, yapılan klinik ve radyolojik muayenesinde alt çeneye inokule yabancı cisimler tespit edildi. Hasta kaza sonrasında başvurduğu sağlık merkezinden ilk müdahalenin ardından cisim çıkarılmadan taburcu edilmiş, ağrılarının devam etmesi üzerine hasta aynı merkezden alt çene fraktürü teşhisiyle sevk edilmişti. İlgili bölgede ileri görüntüleme yöntemleri ile incelendiğinde bile kolayca ayırt edilemeyen radyoopak bir oluşum tespit edildi ve cerrahi olarak çıkarıldı.

SONUÇ: Cerrahi olarak çıkarılan parçaların araba camı olduğu tespit edildi. Bu olgu bildiriminde araba camının alt çene kırığı ile karışabileceği anlatılmış ve tartışılmıştır.

Keywords

Kemik, Mandibula, Panoramik Radyografi, Tomografi, Trafik Kazası, Yabancı Cisimler

References

• Bouajina E, Harzallah L, Ghannouchi M, Hamdi I, Rammeh N, Ben Hamida R, et al. Foreign body granuloma due to unsuspected wooden splinter. Joint Bone Spine 2006;73:329-31.
• Vargas-Machuca I, González-Guerra E, Angulo J, del Carmen Fariña M, Martín L, Requena L. Facial granulomas secondary to Dermalive microimplants: Report of a case with histopathologic differential diagnosis among the granulomas secondary to different injectable permanent filler materials. Am J Dermatopathol 2006;28:173-7.
• Karlı R, Uğur MB, Bahadır B, Gül A, Uzun L. Dev hücreli reperatif granüloma: Olgu sunumu. KBB-Forum 2009;8:39-43.
• Indresano T. Principles of management of maxillofacial trauma. Peterson LJ, ed. Principles of oral and maxillofacial surgery. Philadelphia: J.B. Lippincott Company; 1992. p.267-640.
• Veselko M, Trobec R Intraoperative localization of retained metallic fragments in missile wounds. J Trauma 2000;49:1052-8.
• Charney DB, Manzi JA, Turlik M, Young M. Nonmetallic foreign bodies in the foot: radiography versus xeroradiography. J Foot Surg 1986;25:44-9.
• Glatt HJ, Custer PL, Barrett L, Sartor K. Magnetic resonance imaging and computed tomography in a model of wooden foreign bodies in the orbit. Ophthal Plast Reconstr Surg 1990;6:108-14.
• Martins WD, Fávaro DM, Westphalen FH. Emergency maxillofacial radiology. Foreign body localization: report of cases. Dentomaxillofac Radiol 2005;34:189-92.
• Eggers G, Mukhamadiev D, Hassfeld S. Detection of foreign bodies of the head with digital volume tomography. Dentomaxillofac Radiol 2005;34:74-9.
• Oikarinen KS, Nieminen TM, Mäkäräinen H, Pyhtinen J. Visibility of foreign bodies in soft tissue in plain radiographs, computed tomography, magnetic resonance imaging, and ultrasound. An in vitro study. Int J Oral Maxillofac Surg 1993;22:119-24.
• Holmes PJ, Miller JR, Gutta R, Louis PJ. Intraoperative imaging techniques: a guide to retrieval of foreign bodies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:614-8.
• Bolliger SA, Oesterhelweg L, Spendlove D, Ross S, Thali MJ. Is differentiation of frequently encountered foreign bodies in corpses possible by Hounsfield density measurement? J Forensic Sci 2009;54:1119-22.
• Aras MH, Miloglu O, Barutcugil C, Kantarci M, Ozcan E, Harorli A. Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography. Dentomaxillofac Radiol 2010;39:72-8.
• Tavargeri AK, Rao CB, Thakur S. Foreign body in the mouth and the dilemma in diagnosis: a case report. J Calif Dent Assoc 2010;38:512-3.