Tongue bite injury after use of transcranial electric stimulation motor-evoked potential monitoring

Williams, Aparna; Singh, Gyaninder Pal

doi:10.4103/0970-9185.137297

Cited by 10 publications

(4 citation statements)

References 9 publications

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“…etc. [13]. A thorough preoperative explanation of expected, although uncommon, complications can go a long way in terms of patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Bhamri¹,

Dey²,

Gupta³

et al. 2022

Cureus

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Anesthesia-related oropharyngeal injuries are known to occur. Risk factors for intraoperative dental injuries include difficult intubation, use of transesophageal echocardiography (TEE) probe, motor-evoked potential (MEP) monitoring, poor dental hygiene, etc. Our patient was a case of a thalamic cavernoma who underwent craniotomy in a sitting position with the neck flexed along with MEP and TEE monitoring. At the end of the surgery, the lower three incisors were found to be subluxated. The subluxated teeth were stabilized using a 2-0 Ethilon suture in the operation room. Immediate dental consultation was sought postoperatively. Sitting position surgeries with associated neck flexion, simultaneous, advanced monitoring techniques like TEE and MEP, poor dental condition, and the use of hard bite blocks can predispose patients to dental injury. Preoperative dental evaluation and explanation of neuromonitoring-associated injuries can be beneficial.

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“…etc. [13]. A thorough preoperative explanation of expected, although uncommon, complications can go a long way in terms of patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Bhamri¹,

Dey²,

Gupta³

et al. 2022

Cureus

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show abstract

“…There is insufficient evidence to demonstrate whether soft bite blocks, such as rolled or taped gauze, or hard bite blocks are better at maintaining airway patency during extubation. There has been some support for use of soft bite blocks as opposed to hard bite blocks in preventing oral injuries, as hard bite blocks may cause pressure injuries and dental trauma [ 91 ]. An oropharyngeal airway has been suggested as a hard bite block which simultaneously provides a patent upper airway [ 7 ].…”

Section: Adjunct Maneuvers To Smooth Extubationmentioning

confidence: 99%

Smooth Extubation and Smooth Emergence Techniques: A Narrative Review

Wong

Weber

Abramowicz

2021

Anesthesiology Research and Practice

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There is a paucity of literature on extubation technique and a lack of consensus regarding the definition of smooth extubation. This narrative review paper defines an ideal extubation, otherwise known as a “smooth extubation,” reviews perioperative criteria for extubation and risks and adverse events related to extubation, and explores various perioperative techniques that can be used to achieve a smooth extubation while caring for an uncomplicated patient without significant risk factors for extubation failure. In light of the evolving practice during the SARS CoV2 (COVID-19) pandemic to minimize aerosol generation and infection transmission, smooth extubation is particularly important.

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“…In many centers, including our center, neurophysiologists and anesthesiologists have tried to use other materials like rolled gauze pieces, or syringes wrapped in gauze as bite guards, and have encountered suboptimal and unreliable performance [2]. Injuries can occur if these materials are kept between the incisor teeth as they can get displaced, or because the sides of the tongue remain unprotected [3]. Though frequent intraoperative checking has been suggested, this is impractical when the patient has been draped for cranial neurosurgery or if the patient is in a prone position.…”

Section: Introductionmentioning

confidence: 99%

How to Make a Do-It-Yourself, Disposable Bite Guard Using Easily Available Materials, to Prevent Tongue and Lip Injuries, During Motor Evoked Potential Monitoring in Neurosurgery

Sasidharan

Karre

2019

Cureus

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Tongue bite injury after use of transcranial electric stimulation motor-evoked potential monitoring

Cited by 10 publications

References 9 publications

Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Intraoperative Dental Injury in a Neurosurgical Patient: Concerns for the Anesthesiologist

Smooth Extubation and Smooth Emergence Techniques: A Narrative Review

How to Make a Do-It-Yourself, Disposable Bite Guard Using Easily Available Materials, to Prevent Tongue and Lip Injuries, During Motor Evoked Potential Monitoring in Neurosurgery

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