Supernumerary teeth usually occur in the gingiva or jawbones and rarely in the nasal cavity. Computed tomography (CT) can be used for identification and diagnosis. Endotracheal intubation can introduce foreign bodies into the trachea, if such bodies are not detected before the induction of anesthesia. Herein, we report the case of a supernumerary tooth that fell into the pharynx during tracheal intubation. A 19-year-old woman was scheduled for a double jaw surgery. An oral surgeon scheduled the extraction of a supernumerary tooth in the maxilla after the double jaw surgery. The radiologist also pointed out the presence of a supernumerary tooth in the right nasal cavity on a preoperative CT image. However, the presence of the supernumerary tooth was not confirmed.
Using a 7.0-mm diameter tracheal tube, we performed nasotracheal intubation via the right nasal cavity because of a narrow left nasal cavity. When the oral surgeon tried to remove the supernumerary tooth after the double jaw surgery, the tooth could not be found. A postoperative radiograph revealed the presence of the supernumerary tooth in the pharynx. After consulting an otolaryngologist, the patient was managed until the next morning with intubation under sedation with propofol and dexmedetomidine hydrochloride. The next day, the tooth was removed from the pharynx without complications. This case illustrates the importance of preoperative examinations, including CT imaging, before tracheal intubation.
