4.2 Article

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

Journal

OTOLOGY & NEUROTOLOGY
Volume 36, Issue 2, Pages e42-e45

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAO.0000000000000690

Keywords

Carotid artery; Cochlea; Cochlear damage; Complication; Dental; Endaural approach; Foreign body; Hearing loss; Migration; Needle; Sensorineural; Skull base

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Objectives Long-term retained foreign bodies in the human body have been reported across many specialties, but relatively few exist in the ENT literature. Patients We 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. Interventions The needle segment was removed through an endaural approach without complication. Results Postoperatively, 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. Conclusion To 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.

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