PMC4010017_01
On the right, pieces of the head of the toothbrush (yellow arrow) immediately after removal from the patients oro-nasopharyngeal junction. On the left, the base of the toothbrush which the patient was found holding after his fall.
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fig1
This revealed the missing head of the toothbrush (Figure 1) lodged horizontally in the lateral walls of the nasopharynx with its sharp end embedded in the left lateral pharyngeal wall.
CT angiography of the head and neck showing a hematoma shaped like the head of the toothbrush in the right nasopharynx (white arrow) and the aneurysmatic dilatation of the origin of the internal maxillary artery (yellow arrow).
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fig2
This showed a long, hypodense region in the right nasopharynx suspect for a hematoma as well as an aneurysmatic dilatation of the origin of the right internal maxillary artery (Figure 2).
Conventional angiography of the head and neck showing the pseudoaneurysm at the base of the internal maxillary artery (white arrow) and the coil (yellow arrow) closing the pseudoaneurysm successfully.
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fig3
The subsequently performed conventional angiography confirmed the presence of an internal maxillary artery pseudoaneurysm, approximately 2 cm after the bifurcation of the arteria carotis communis which was successfully coiled (Figure 3).