To summarize the clinical experience of removing infratemporal fossa and pterygopalatine fossa foreign bodies via a trans-oral approach.

The clinical data of 9 patients with foreign bodies in the infratemporal fossa and pterygopalatine fossa hospitalized from March 2008 to June 2017 were analyzed retrospectively. Among these cases, 4 were flying injuries, 2 were falling injuries, 2 were traffic injuries and 1 was an iatrogenic syringe injury. Foreign bodies were divided into the following categories: 3 cases of wood from branches, 3 cases of iron filings, 2 cases of broken glass, and one case of a broken syringe needle. Before surgery, all subjects underwent spiral CT three-dimensional reconstruction and CT angiography examinations. After accurately determining the relationship between the foreign body and the internal and external carotid arteries and their branches, patients underwent an operation under general anesthesia to remove the foreign body via a trans-oral approach. In addition, patients participated in mouth opening training for one week. Then, patients were followed for 1 to 6 months.

Foreign bodies were removed completely in all 9 patients. Foreign bodies were independently located in the pterygopalatine fossa in 2 cases and in the in fratemporal fossa in 3 cases. There were 4 cases of foreign bodies located in both the infratemporal fossa and the pterygopalatine fossa. All 9 patients had the foreign bodies completely removed and were discharged one week after surgery. They were followed for 1 to 6 months. Their mouth opening and occlusion were normal, without any complications.

Spiral CT, 3D reconstruction and CT angiography examinations are necessary and important for accurate pre-operation positioning. It is feasible to remove foreign bodies in the infratemporal fossa and pterygopalatine fossa via a trans-oral approach.

The present study evaluated postoperative reactions in adjacent teeth after the extraction of lower-level horizontal-impacted mandibular third molars using a T-shaped splitting method.

A total of 101 patients with lower-level horizontal impaction of mandibular third molars were selected and randomly divided into two groups. The impacted mandibular third molar was extracted using a T-shaped splitting method in group A (56 cases)，and the traditional two-section method was used in group B (45 cases)。Postoperative reactions，including temperature sensitivity，percussion pain and mobility in the adjacent teeth，were compared between the 2 groups at 1-week，2-week，and 1-month follow-up visits. The SPSS 13.0 software package was used for the statistical analysis.

The postoperative reactions of temperature sensitivity (χ_1w²= 11.81，χ_2w² = 17.43，P < 0.05)，percussion pain (χ_1w² = 8.70，χ_2w² = 4.75，P < 0.05)and mobility (χ_1w² = 4.50，χ_2w² = 7.10，P < 0.05)in adjacent teeth in group A were significantly less than those in group B at the 1-week and 2-week follow-up visits. The temperature sensitivity in adjacent teeth in group A was significantly less than that in group B at the 1-month follow-up visit (χ² = 7.10，P < 0.05)，but percussion pain and mobility in adjacent teeth disappeared in both groups.

The T-shaped splitting method for the extraction of mandibular lower-level horizontal impacted third molars can reduce the postoperative reactions in adjacent teeth.