Background
The appropriate management of postoperative complication of wisdom teeth removal is of utmost importance as it can result in legal procedures.
The accidental displacement of a maxillary third molar in the infratemporal fossa (ITF), is a rare complication that can occur even with experienced surgeons.
The numerous retrieval techniques reported are invasive and provide an unpredictable access.
Our aim was to achieve the safe and swift retrieval of the tooth displaced to an area of such complex anatomy.
Case presentation
We describe the case of a 17-year-old female patient whose right upper third molar was accidentally pushed upward to the ITF and became unreachable.
Retrieval based on interventional radiology using the CT-guided placement of a bone trocar above the displaced tooth was successfully performed. The postoperative course was uneventful.
Conclusions
CT scan assisted interventional radiology provides both, real-time assessment of the tooth position through image refreshment, and steady stabilization of the displaced tooth. Therefore, it allows a safe and non-traumatic retrieval with a time-efficient procedure achieved through a minimally-invasive approach with inconspicuous scaring. We believe that such a procedure is an interesting treatment option for optimal outpatient care.
To our knowledge, no such case has been previously described.
Electronic supplementary material
The online version of this article (10.1186/s12903-019-0852-z) contains supplementary material, which is available to authorized users.
We studied gastro-oesophageal reflux (GOR) with a face mask and laryngeal mask airway (LMA), and the effects of inflation pressure and volume of the LMA cuff on oesophageal pH, in 60 patients. Patients were managed with either a face mask (group I) or LMA inflated to obtain a seal in the anaesthesia circuit at 7 cm H2O (group II) or 15 cm H2O (group III). A pH-sensitive probe with two electrodes, 10 cm apart, was placed in the oesophagus during anaesthesia and recordings were made continuously until patients awakened. There was a significant difference in the incidence of GOR between the face mask (group I) and the LMA (groups II-III) (P < 0.05) in the lower oesophagus but there was no difference in the mid-oesophagus. No correlation was found between pressure and volume inside the cuff and variations in oesophageal pH. We conclude that LMA use was associated with increased reflux in the low oesophagus but oesophageal pH was not influenced by variations in pressure or volume inside the LMA cuff.
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