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

神经外科患者术中牙齿损伤:麻醉医师需关注的问题

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Abstract

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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