Retained Dental Needle Migration Across the Skull Base to the Cochlea Presenting as Hearing Loss

• Published in: Otology & neurotology Vol. 36; no. 2; pp. e42 - e45
• Main Authors: Casey, Justin T, Lupo, J Eric, Jenkins, Herman A
• Format: Journal Article
• Language: English
• Published: United States Copyright by Otology & Neurotology, Inc. Image copyright Wolters Kluwer Health/Anatomical Chart Company 01-02-2015
• Subjects: Carotid Artery, Internal - diagnostic imaging; Carotid Artery, Internal - surgery; Cochlea - diagnostic imaging; Cochlea - surgery; Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; Foreign Bodies - surgery; Foreign-Body Migration - complications; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - surgery; Hearing Loss - diagnostic imaging; Hearing Loss - etiology; Hearing Loss - surgery; Humans; Male; Middle Aged; Needles; Skull Base - diagnostic imaging; Skull Base - surgery; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1531-7129; 1537-4505
• DOI: 10.1097/MAO.0000000000000690

OBJECTIVESLong-term retained foreign bodies in the human body have been reported across many specialties, but relatively few exist in the ENT literature.
PATIENTSWe present a case report of a patient with a broken dental needle fragment in the posterior oral cavity with subsequent migration to the cochlea over the course of 4 years, eventually leading to hearing loss. CT scan and middle ear exploration demonstrated a 4-cm metallic fragment abutting the base of the cochlea, immediately adjacent to the internal carotid artery.
INTERVENTIONSThe needle segment was removed through an endaural approach without complication.
RESULTSPostoperatively, the patient had improvements in PTA and speech discrimination, as well as the resolution of chronic otalgia and jaw pain. Imaging, audiologic results, and surgical details and pictures are presented herein.
CONCLUSIONTo our knowledge, based on a thorough PubMed and Google Scholar search, there are no reports of such a foreign body migration from the oral cavity to the skull base.