Abstract
In daily clinical practice of oral surgery, knowledge of psychiatric disorders and appropriate treatment are indispensable. Schizophrenia, bipolar disorder, autism spectrum disorder, and depression are known to be the four major mental disorders, and cause social problems. Oral and maxillofacial surgeons are commonly required to treat patients with these diseases. A 21-year-old female patient had asthma, bipolar disorder, attention-deficit/hyperactivity disorder （ADHD）, dissociative disorder, dissociative amnesia, and suicide attempt. The patient attempted to insert a 1.3mm diameter, 50.0mm long piercing needle into her tongue on her own. However, she could not remove the needle and decided on overnight observation. The next day, the patient was admitted to our department with fever and tongue pain, and was urgently hospitalized for anti-inflammatory treatment and removal of the needle. Computed tomography showed the needle intruding from the back of the tongue to the lower part of the mandible, and so extraoral removal of the foreign body was performed under general anesthesia. Drainage was performed due to pus from the wound. During hospitalization, the patient developed mental problems, such as a marked tendency toward somnolence and emotional incontinence, but was discharged from the hospital 4 days after surgery because of good wound healing. We report this case in which a needle used for body piercing by a patient with multiple psychiatric disorders strayed into the tongue, with a review of the literature.
