RESUMO
Foreign body aspiration is a serious problem that may lead to complications or even death. People who sustain major maxillofacial trauma can often damage their teeth or oral prostheses, and aspiration can occur. Detection of this type of aspiration can be difficult, especially in elderly people wearing dental appliances, since many dental prostheses are not radiopaque and the aspiration is not always recognized at the time of injury. We report a specific case of extensive maxillofacial trauma from a self-inflicted gunshot wound leading to aspiration of large, radiolucent denture fragments, delayed diagnosis, and complications. The possibility of denture fragment aspiration must always be part of the differential diagnosis in an elderly trauma patient presenting with dyspnea, hypoxia or, eventually, pneumonia. This is especially so when radiologic evaluation does not reveal a foreign body, since much dental prosthesis material is radiolucent. Delayed complications of radiolucent dental prosthesis aspiration could be avoided by the inclusion of some radiopaque material within the acrylic material of the prosthesis.
Assuntos
Dentaduras , Traumatismos Faciais/cirurgia , Corpos Estranhos/cirurgia , Ferimentos por Arma de Fogo/complicações , Idoso , Traumatismos Faciais/diagnóstico , Traumatismos Faciais/etiologia , Evolução Fatal , Corpos Estranhos/diagnóstico por imagem , Humanos , Escala de Gravidade do Ferimento , Masculino , Insuficiência de Múltiplos Órgãos/diagnóstico , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/fisiopatologia , Aspiração Respiratória , Tentativa de Suicídio , Tomografia Computadorizada por Raios X/métodosAssuntos
Ritidoplastia/métodos , Anestesia , Dissecação , Endoscopia , Testa , Humanos , Ritidoplastia/efeitos adversos , Ritidoplastia/instrumentaçãoRESUMO
BACKGROUND AND PURPOSE: Recent advances in the display of medical images permit the routine study of temporal bone CT images at high magnification. We noted an unfamiliar structure, which we now call the "cochlear cleft," in the otic capsule. To our knowledge, this report represents the first description of this structure in the medical imaging literature. METHODS: Temporal bone CT performed in 100 pediatric patients without sensorineural hearing loss were examined for the presence of cochlear clefts. Incidence of cochlear clefts as well as the relationship between age and incidence was examined. RESULTS: Cochlear clefts were present in 41% of the subjects. Incidence decreased with age. CONCLUSION: We describe a cleft in the otic capsule that is frequently seen on magnified images of temporal bone CT studies in children. The cleft may be the fissula ante fenestram.
