Importance of the use of pre- and intra-operative imaging as a tool for planning foreign body removal in the floor of the mouth: A Case Report.

Veronica Viloria; Carlos Millán-Golindano; Josmar García; Laura Molina; Jose Gregorio Melillove; Ramses Palma

doi:10.17126/joralres.2022.015

Veronica Viloria Hospital General del Oeste. Caracas, Venezuela.
Carlos Millán-Golindano Hospital General del Oeste. Caracas, Venezuela.
Josmar García Hospital General del Oeste. Caracas, Venezuela.
Laura Molina Hospital General del Oeste. Caracas, Venezuela.
Jose Gregorio Melillove Universidad de Buenos Aires, Argentina. | School Hospital Militar Dr Carlos Arvelo. Caracas, Venezuela.
Ramses Palma Universidad de Chile. Santiago, Chile.

DOI: https://doi.org/10.17126/joralres.2022.015

Abstract

Introduction: Body piercings consist of small holes made with a needle in different parts of the skin or body to introduce a jewel or decorative element. In the oral cavity, most piercings are placed in the tongue. However, some complications may occur, and surgical techniques must be used for their removal. These complications present a certain degree of difficulty due to their position and may challenge the ability of the clinician to access the specific anatomical location. The different imaging techniques, from simple radiography to intraoperative techniques such as image intensifiers, have become an extremely useful tool for locating an object in the three dimensions of space, allowing safe location and extraction.
Objective: The aim of this study is to report the case of a complication of a body piercing in the oral cavity and how the use of imaging was decisive for surgical planning and for the quick and effective resolution of the case.
Material and Methods: A 14-year-old female patient came looking for treatment. Her mother reported the onset of the condition after the insertion of a needle-like metallic object while performing an artistic perforation in the lingual region. Since the girl was unable to extract the object, she sought medical advice at the Carlos Arvelo Military Hospital in Caracas, Venezuela. Subsequently, an imaging study was performed by means of a Computed Tomography to locate the metallic object. It was observed that the foreign body had migrated to the floor of the mouth/sublingual region, requiring the area to be surgically approached. It was also decided to use an intraoperative image intensifier. The removal of the object was performed satisfactorily.
Conclusion: The extraction of foreign bodies placed in the lingual and sublingual region represents a challenge for the clinician due to the number of important anatomical structures that pass through that area. This makes clinicians plan their surgical removal using pre- and intraoperative imaging, to find a less traumatic location, reduce surgical time as well as the risk of damaging adjacent anatomical structures.

References

[1]. Takaoka K, Hashitani S, Toyohara Y, Noguchi K, Urade M. Migration of a foreign body (staple) from the oral floor to the submandibular space: case report. Br J Oral Maxillofac Surg. 2010;48(2):145-146. doi: 10.1016/j.bjoms.2009.04.022. PMID: 19467745.

[2]. Shehata E, Moussa K, Al-Gorashi A. A foreign body in the floor of the mouth. Saudi Dent J. 2010; 22(3):141–143. doi.org/10.1016/j.sdentj.2010.04.008

[3]. Pérez-Cotapos S María Luisa, Cossio T María Laura. Tatuajes y perforaciones en adolescentes. Rev Méd Chile. 2006; 134: 1322-9.

[4]. Ferrer AL, Sanz LP. Piercings y tatuajes: implicaciones para la salud dermatológica. Farmacia profesional. 2009;23(3):46-9.

[5]. Pujalte BF, Fornes PDF, Talamante CS. Complicaciones y cuidados de los piercings y los tatuajes (1ª parte). Enfermería Dermatológica. 2011; 13-14 (2011): 22-28.

[6]. Pujalte, Begoña Fornes, Paula Díez Fornes, and Concepción Sierra Talamantes. Complicaciones y cuidados de los piercings y los tatuajes (2ª parte). Enfermería Dermatológica 6.15 (2012): 8-14.

[7]. Paltas Miranda ME, Taipicaña Guano PV, Andrade Peñafiel AL, Haye Biazevic MG. Cuerpo extraño en región de tercer molar inferior: reporte de caso. Rev. Odontol. 22.2 (2020): 108-118. doi: 10.29166/odontologia.vol22.n2.2020-108-118

[8]. Moore UJ, Fanibunda K, Gross MJ. The use of a metal detector for localisation of a metallic foreign body in the floor of the mouth. Br J Oral Maxillofac Surg. 1993;31(3):191-2. doi: 10.1016/0266-4356(93)90125-g. PMID: 8512917.

[9]. Moreno Daza GA, Dávila Solórzano LB, Moreno Ortega JJ, Moreno Moreno FE. Uso de intensificador de imágenes en extracción de cuerpos extraños radiopacos en traumatología. RECIMUNDO. 2022;2(3):500-9.

[10]. Geary PM. Removal of foreign bodies using hydrostatic pressure. Br J Plast Surg. 2005;58(7):1033-5. doi: 10.1016/j.bjps.2005.05.004. PMID: 16055102.

[11]. 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(5):614-8. doi: 10.1016/j.tripleo.2005.02. 072. PMID: 16243249.

[12]. Gans BJ, Kallal RH, Helgerson AC, Verona SR. The image intensifier in oral and maxillofacial surgery. J Oral Maxillofac Surg. 1982;40(11):726-9. doi: 10.1016/0278-2391(82)90146-x. PMID: 6957560.

[13]. Shehata E, Moussa K, Al-Gorashi A. A foreign body in the floor of the mouth. Saudi Dent J. 2010 Jul;22(3):141-3. doi: 10.1016/j.sdentj.2010.04.008. PMID: 23960490; PMCID: PMC3723269.