2022 Volume 68 Issue 5 Pages 346-351
An impalement wound is a form of traumatic injury in which a blunt-tipped, stick-like object pierces the body. Oral and pharyngeal trauma often occurs when a person falls with an instrument in their mouth, and the most common causative instrument is a toothbrush. In this study, we experienced a case of toothbrush impalement injury that penetrated the parapharyngeal space. The patient was a 67-year-old woman who fell while holding a toothbrush in her mouth. The toothbrush penetrated the parapharyngeal space from the left wall of the middle pharynx and reached the left posterior cervical muscles. The internal carotid artery was significantly narrowed by the toothbrush. The toothbrush was removed from the head side of the toothbrush through an external neck incision. There was no bleeding during removal and the wound healed without subsequent infection. When treating patients with pharyngeal impalement wounds, inadvertent removal may result in massive bleeding due to vascular injury or nerve damage. Thus, it is necessary to select an appropriate removal method after observing the anatomical structures by contrast-enhanced CT or angiography. In addition, impalement wounds can cause serious complications, including abscess and other infections, and traumatic internal carotid artery occlusion a few days after injury. It is therefore important to provide appropriate antimicrobial treatment and follow-up of neurological findings.
