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0:01

I'd like to relook at this child who fell out of the stroller and

0:06

look at the facial bones from the standpoint of

0:11

nasal bone fractures. So as we scroll upward,

0:15

we're going to ignore the patient's orbital fractures

0:17

and now focus on the nasal bones.

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And what you can see is a comminuted fracture of the right

0:24

nasal bone which is indented inward and

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displaced from its normal appearance.

0:30

Here we can see some of the sutures that are associated

0:34

with the nasal bones, and they actually are not involved.

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This is angulated,

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but the fracture is actually more distal to that.

0:42

If we look at the superior, most aspect of the nasal bones,

0:47

we see that there is a fracture which is going through the

0:52

superior anterior portion of the nasal bones and then down

0:56

to this line here. Looking at that on the coronal image,

1:01

what you see is a fracture line which is

1:03

just to the right of the crista galli.

1:07

And this is going downward in orientation just to the right

1:11

of midline and entering into the frontonasal suture.

1:15

So this is an example of a fracture that is going into the

1:20

frontal bone and projecting downward to the frontonasal

1:25

suture as well as involvement of the right nasal bone

1:30

at the frontomaxillary suture seen on the right side.

1:37

Notice that if we look at the nasal septum again,

1:40

something important to look at repeatedly is to look for

1:44

the integrity of this septum and that looks just fine.

1:48

So, an example of right-side nasal fracture

1:51

as well as frontonasal suture fracture.

Case 5 - Cominuted Nasal Bone Fracture

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0:01

I'd like to relook at this child who fell out of the stroller and

0:06

look at the facial bones from the standpoint of

0:11

nasal bone fractures. So as we scroll upward,

0:15

we're going to ignore the patient's orbital fractures

0:17

and now focus on the nasal bones.

0:19

And what you can see is a comminuted fracture of the right

0:24

nasal bone which is indented inward and

0:27

displaced from its normal appearance.

0:30

Here we can see some of the sutures that are associated

0:34

with the nasal bones, and they actually are not involved.

0:36

This is angulated,

0:38

but the fracture is actually more distal to that.

0:42

If we look at the superior, most aspect of the nasal bones,

0:47

we see that there is a fracture which is going through the

0:52

superior anterior portion of the nasal bones and then down

0:56

to this line here. Looking at that on the coronal image,

1:01

what you see is a fracture line which is

1:03

just to the right of the crista galli.

1:07

And this is going downward in orientation just to the right

1:11

of midline and entering into the frontonasal suture.

1:15

So this is an example of a fracture that is going into the

1:20

frontal bone and projecting downward to the frontonasal

1:25

suture as well as involvement of the right nasal bone

1:30

at the frontomaxillary suture seen on the right side.

1:37

Notice that if we look at the nasal septum again,

1:40

something important to look at repeatedly is to look for

1:44

the integrity of this septum and that looks just fine.

1:48

So, an example of right-side nasal fracture

1:51

as well as frontonasal suture fracture.

Report

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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