{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:10:01Z","timestamp":1756321801805,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,11,2]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>A 2-year-old female child with craniosynostosis was referred to our unit for definitive management. She presented with a turricephalic head, hypoplastic midface and obstructive sleep apnoea. Routine preoperative workup included radiographs, CT and polysomnography. She was provisionally planned for calvarial remodelling and midface advancement using transfacial pin fixated distractor (TPF). This involves insertion of a K-wire from one zygoma to the other, a few millimetres below the orbits, traversing across maxilla and nasal cavity. The ends of K-wire are then connected to the distractor anchored firmly to the temporal bone. During insertion, the K-wire transected the nasogastric tube. This technical disaster was circumvented by endoscopic-guided disengagement prior to recovery. The purpose of this paper is to discuss the probable causes that lead to such untoward instances and strategies to avoid and manage the same.<\/jats:p>","DOI":"10.1136\/bcr-2019-230940","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T04:54:19Z","timestamp":1577163259000},"page":"e230940","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unique mishap following transfacial pin fixated midface distraction and successful management using nasal endoscopy"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7636-4247","authenticated-orcid":false,"given":"Naveenkumar","family":"Jayakumar","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thirunavukarasu","family":"Saravanamuthu","sequence":"additional","affiliation":[{"name":"Paediatric Otolaryngology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chidambaram","family":"Balasubramaniam","sequence":"additional","affiliation":[{"name":"Paediatric Neurosurgery, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh","family":"Singaravelu","sequence":"additional","affiliation":[{"name":"Anesthesia, Kanchi Kamakoti Childs Trust Hospital, Nungambakkam, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"2025082711372235000_12.12.e230940.1","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/00001665-199803000-00003","article-title":"Distraction osteogenesis and its application to the midface and bony orbit in craniosynostosis syndromes","volume":"9","author":"Toth","year":"1998","journal-title":"J Craniofac Surg"},{"key":"2025082711372235000_12.12.e230940.2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0294-1260(01)00041-3","article-title":"[Mid-facial distraction without osteotomy with a trans-facial pin. Report of 4 clinical cases]","volume":"46","author":"Pellerin","year":"2001","journal-title":"Ann Chir Plast Esthet"},{"key":"2025082711372235000_12.12.e230940.3","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/SCS.0b013e3182418f80","article-title":"Midfacial distraction without osteotomy using a transfacial pin and external devices","volume":"23","author":"Coeugniet","year":"2012","journal-title":"J Craniofac Surg"},{"key":"2025082711372235000_12.12.e230940.4","unstructured":"Marchac D , Renier D , Guerrero P . Lethal complications after craniofacial surgery. In: Marchac D , ed. Craniofacial surgery. Proceedings of the sixth international Congress of the International Society of craniofacial surgery. Bologna, Italy: Monduggi, 1995: 225\u20138."},{"key":"2025082711372235000_12.12.e230940.5","doi-asserted-by":"crossref","first-page":"291","DOI":"10.24015\/JAPM.2017.0085","article-title":"Transection of flexometallic endotracheal tube during Le Fort\u2019s osteotomy","volume":"4","author":"Nair","year":"2017","journal-title":"J Anesth Perioper Med"},{"key":"2025082711372235000_12.12.e230940.6","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4103\/0019-5049.82689","article-title":"Accidental transection of flexometallic endotracheal tube during partial maxillectomy","volume":"55","author":"Ladi","year":"2011","journal-title":"Indian J Anaesth"},{"key":"2025082711372235000_12.12.e230940.7","doi-asserted-by":"crossref","first-page":"347","DOI":"10.4103\/ija.IJA_674_16","article-title":"Management of an intraoperatively damaged endotracheal tube in a case of difficult airway using fibre-optic bronchoscope with minimal apnoea period","volume":"61","author":"Himarani","year":"2017","journal-title":"Indian J Anaesth"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230940","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:37:30Z","timestamp":1756319850000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230940"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":7,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12,23]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bcr-2019-230940"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230940","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}