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Case 5 - Nasal Bone Fracture Summary

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As you've seen by some of my examples,

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nasal bone fractures don't often occur in isolation.

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They often have associated fractures.

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Here's an example of a patient who has multiple,

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"nasal bone fractures", as well as other

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fractures. So if we look in the first image,

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we see that the anterior nasal or maxillary

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spine here has been fractured.

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This is a fracture that is very easily demonstrated on sagittal

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reconstructions as long as you do them with thin enough

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sections. If it's too wide a section, unfortunately,

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you may get partial volume averaging

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and you may not see the fracture.

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But this little spine here is referred to as the anterior

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nasal spine or the anterior maxillary

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spine or the maxillary spine.

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And this is, again, part of that complex

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of a nasal bone fracture,

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even though it really doesn't involve

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the nasal bones themselves.

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Here you have a fracture that do involve the nasal bones,

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not only of the nasal bones, but also

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of that suture that I mentioned previously.

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This little asterisk here,

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which is demonstrating the nasomaxillary suture,

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which is this structure, which is coming down right along here.

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That's to be separated from the frontomaxillary suture, which we

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will see in just a moment as part of the naso-orbito-ethmoidal

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complex. So, fractures of the nasal bone as well

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as the nasomaxillary suture. And here's,

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the nasal bone fracture on the sagittal.

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In addition,

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you notice that this patient's anterior portion

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of the maxillary antrum has been fractured.

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But this anterior portion of the maxillary antrum is the common

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wall with the orbital rim, as well as more posteriorly,

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the orbital floor affecting the infraorbital nerve.

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This fracture extends to involve the nasolacrimal duct.

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So, what you're seeing

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are these little areas right here and right here.

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So let me remove the... and you can see the wall of the normal

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nasolacrimal duct has been fractured

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with a free fragment right here.

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So that's the nasolacrimal duct fracture. A portion, again,

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that we will talk to in just a moment about the naso-orbito

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ethmoidal complex. And in addition,

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the medial maxillary wall has been violated.

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So multiple fractures, not just including the nasal bones.

Report

Summary

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Head and Neck

Emergency

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