C-Arm Fluoroscopy: A Reliable Modality for Retrieval of Foreign Bodies in the Maxillofacial Region

Abstract

The anatomic complexity of the maxillofacial region makes the retrieval of foreign bodies a daunting task for the maxillofacial Surgeon. Moreover the inability of 2-dimensional imaging to precisely locate foreign bodies makes it challenging. The anatomic proximity of critical structures and esthetic considerations limits the access and thus poses a greater challenge for the surgeon in cases of foreign body retrieval. Hereby we propose a simple technique and a case report to support, the retrieval of small (<5 mm greatest dimension) objects from the maxillofacial region. The present technique uses a 2 dimensional mobile C arm Fluoroscopy and a needle triangulation method to precisely locate a loosened miniplate screw in the mandibular angle region. How to cite this article Pandyan D, Nandakumar N, Qayyumi BN, Kumar S. C-Arm Fluoroscopy: A Reliable Modality for Retrieval of Foreign Bodies in the Maxillofacial Region. J Contemp Dent Pract 2013;14(6):1193-1196.

Surgical Removal of an Orthodontic Mini-Screw Displaced Into the Lateral Pharyngeal Space: A Case Report and Review of Pertinent Literature

“…Additionally, fluoroscopy using a portable C-Arm x-ray imaging system was used with a metallic dissecting forceps as a radiographic reference (Figure 4). Several studies have reported the advantages of using fluoroscopy for intraoperative imaging of foreign bodies, as it enables anatomic visualization in multiple planes [5,[9][10][11][12]. In most of the above studies, a C-Arm x-ray system was the preferred method of fluoroscopic imaging, as was the case in the present study too.…”

“…In scenarios wherein the foreign body displacement is witnessed clinically, imaging modalities play the role of the next important diagnostic tool. Plain radiographs and advanced imaging techniques such as ultrasonography, magnetic resonance imaging (MRI) and CT help localize the anatomic location of the foreign body and vital structures in its proximity [ 2 , 4 , 7 , 11 ].…”

“…In this regard, fluoroscopy (C-Arm mobile imaging system), a real-time imaging modality that uses X-rays for visualizing movements of instruments and implants within body parts during surgery, has found an application in surgical retrieval of foreign bodies. In addition to helping visualize the dislodged foreign body in real-time, C-Arm fluoroscopy has also enabled indirect yet guided access to the fascial spaces in the head and neck, which are anatomically complex due to their location and associated structures [9][10][11].…”

Use of an image intensifier for the localization and removal of a foreign body in the lower lip

“…It is essential detect the exact location of FB for removal 2,4 . However, identifying the position of these objects and determining a safe surgical approach are difficult using conventional preoperative radiography 5 .…”

“…It was first used in neurosurgery to improve the imaging of brain tumors, cysts, edema and diagnosis of central nervous system diseases 7 . The benefit exceeds surgery on the brain; fluoroscopy has been used a non -invasive method for guided surgical, due to the accuracy of location for removal of FB 4 . Also others reports demonstrate that fluoroscopy improves the management and resolution to removal of broken instruments and neddles in soft and hard tissue 3,8,9 .…”