Multidisciplinary management of intracranial migration of a fractured dental needle through the foramen ovale: a case report.

Abstract

Local anaesthesia and nerve block are common practices in dental therapy. Although they are associated with low rate of complications, local events such as needle fracture could entail life threatening consequences. We present a case of a needle fracture in a 4 year old girl who underwent a minor dental procedure. The needle migrated intracranially through the foramen ovale. She required a multidisciplinary management with a final neurosurgical intervention in order to remove it. In addition to an initial diagnostic computerized tomography (CT), it was of utmost importance to have access to an intraoperative imaging tools (preferably low radiation CT in paediatric population) to monitor the potential risk of needle migration. This report demonstrates that a broken needle may migrate intracranially, among other complications, underscoring the importance of managing these cases in a tertiary referral hospital with the appropriate equipment and specialists.