Gossypiboma during orthognathic surgery: A case report
| Autor: | Randa Alfotawi, Mohammed Alkindi, Osama A Ibraheim, Saleh Zaid Alshehri, Razan A. Ababtain |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Nasal cavity
medicine.medical_specialty Under anaesthesia Complications medicine.medical_treatment Gossypiboma Orthognathic surgery Case Report 03 medical and health sciences 0302 clinical medicine medicine Sore throat Unretrieved device fragment (UDF) business.industry medicine.disease Surgery Aspiration medicine.anatomical_structure Surgical Manipulation 030220 oncology & carcinogenesis Vomiting 030211 gastroenterology & hepatology medicine.symptom Complication business Temperature probe Hazard |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • An unusual case of Unretrieved Device Fragment (UDF) at patient’s hypopharynx for 21 days. • First reported complication after orthognathic surgery. • This incidence has changed the routine anaesthetic procedure protocol. • Update our time out check list of to include “complete removal of temperature probe. Introduction Dislodgment of nasopharyngeal temperature probes and/or unretrieved device fragments (UDFs) or gossypibome at a patient’s hypopharynx is rare complication after orthognathic surgery that may occur as a result of surgical manipulation or may be a consequence of factors related to the insertion and handling of the probe after extubation. However, the exact mechanism of this complication is unknown. To the best of our knowledge, this is the 1st reported case of a missing temperature probe after orthognathic surgery. Case presentation We report the case of a patient who suffered from dislodgment of a 12-cm temperature probe after orthognathic surgery. The surgery was uneventful. At the end of the surgery, the probe was believed to have been completely removed from the nasal cavity. The nasopharyngeal cavity was visually inspected while the patient was still under anaesthesia and the trachea was still intubated. Extubation was successful, and the patient was moved to the recovery area. The patient was discharged from the hospital one day after resuming an oral fluid diet. At the follow-up visit on the 4th postoperative day, the patient presented with mild symptoms of a sore throat and cough. At the follow-up visit in the 3rd postoperative week, the patient reported one episode of vomiting and severe coughing, and the patient ultimately retrieved the 12-cm temperature probe from her mouth. Discussion After conducting a systematic literature review, we discuss surgical cases involving UDFs or gossypiboma. We also describe changes in our clinical practice after this event, and we envision that these modifications will have a positive influence on patient care. We believe that alternative routes for inserting temperature probes with covers would be suitable for orthognathic surgery. Conclusion Vigilance should be maintained during patient extubation by both teams (surgeons and anaesthetists) to assure that part of the probe always remains visible outside the oral/nasal cavity as well as complete removal of the device to avoid this life-threating complication. |
| Databáze: | OpenAIRE |
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