Abstract
Oral and oropharyngeal trauma due to falling while holding a toothbrush in the mouth is often experienced by children; however, it is less common in adults. In the case of oral and oropharyngeal trauma by toothbrush, even if the local findings are minor, there may be serious complications such as damage to major blood vessels or the central nervous system, deep cervical or mediastinal emphysema, or mediastinal abscess. Therefore, such cases require careful and thorough examination and diagnosis, including imaging studies. Herein, we present a case of a 72-year-old woman who had an intraoral impalement injury with a toothbrush that reached the parapharyngeal space caused by a fall.
She had a history of rheumatoid arthritis and eosinophilic granulomatosis with polyangiitis and was taking warfarin potassium. On initial examination, there was no evidence of persistent bleeding. The CT scan showed that the tip of the toothbrush had reached the parapharyngeal space, and emphysema had extended around the carotid sheath. On the same day, due to concerns about the possibility of hematoma increase over time in the cervical interspaces, the patient was admitted to the hospital and managed with no food or liquids, warfarin was withdrawn, and transvenous antibacterial agents were administered. Furthermore, we punctured the already-closed wound on the anterior pharyngeal arch to facilitate drainage. The inflammatory findings were reduced without serious complications, and the patient was discharged 6 days post-hospitalization.
