Should the Surgical Instrument Parts That Are Broken and Remain in the Distance of the Disc Be Removed? Should It Be Quit? A Case Report

Background and Aim: Lumbar posterior open microdiscectomy is a procedure that is widely used to treat lumbar disc diseases. These operations have a low risk of complications. It is unusual for the tool to break and remain in the intervertebral space during surgery. In this situation, we wanted to provide a set of suggestions based on our research of the literature on pituitary forceps blade fractures and the procedure for removing the fractured portion from the disc space during lumbar posterior open microdiscectomy surgery. Case Presentation: 10 days ago, a 37-year-old female patient presented to our clinic complaining of low back pain, left leg pain, and left foot weakness. A diagnosis of lumbar disc herniation necessitating surgery was obtained following neurological and radiographic examinations. The patient was advised to have surgery. The patient had standard lumbar microdiscectomy surgery. However, the tip of the pituitary forceps was broken during disc removal and remained in the L5-S1 disc space. The scope confirmed that the alien object was in space. After the evaluation, it was decided to remove the piece of instrument that was broken and remained in the disc space. The broken surgical handpiece was removed and documented under fluoroscopy. Additionally, it was forwarded to the technical unit for examination. Conclusion: A few case reports in the literature describe a surgical tool piece fracture that remained in the disc distance of the lumbar microdiscectomy. Complication management may be time-consuming and risky. Such a complication should be addressed and resolved appropriately because this situation might have detrimental terms on surgical risks and the legal procedure.

Nasal septal foreign body as a complication of dental root canal therapy: A case report

BACKGROUND Currently,there have been no reports on foreign bodies found in the nasal septum after dental root canal therapy.Herein,we present an unusual case of a foreign body found in the nasal septum,which occurred after dental root canal therapy and two unsuccessful surgeries.CASE SUMMARY A 55-year-old man was referred to our department due to slight nasal discomfort that persisted for about 1 wk.Before consulting our department,the patient visited three different hospitals/clinics and underwent two surgeries that were not successful in removing a foreign body completely.A computed tomography scan was performed to detect the shift of the foreign body from dental root to the nasal septum,which resulted in the healing of oral inflammation and nasal septum discomfort.An endoscopic foreign body extraction surgery(3rd removal surgery)was then successfully performed,using a needle as the reference.No nasal reconstruction was required after the operation.Postoperative healing was uneventful.CONCLUSION Medical healthcare professionals should consider past medical history when dealing with foreign body cases.During septal foreign body extraction surgery,a needle could be used as a helpful reference.