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Medial maxillary (nasomaxillary buttress) fracture: Two case reports
Masaru Ogawa1, Satoshi Yokoo, Hidenori Nakamura
1Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Showa-machi, Maebashi City, Gunma, Japan.
Medicine
|November 19, 2022
Summary
Medial maxillary (nasomaxillary buttress) fractures are challenging to diagnose due to similarities with other facial fractures. Accurate differential diagnosis is crucial for appropriate surgical treatment planning.
Area of Science:
- Maxillofacial surgery
- Trauma surgery
- Orthognathic surgery
Background:
- Medial maxillary fractures, involving the nasomaxillary buttress, present diagnostic challenges.
- These fractures often mimic nasal and naso-orbito-ethmoidal (NOE) fractures, complicating accurate identification.
- Current classifications do not specifically address medial maxillary (nasomaxillary buttress) fractures.
Observation:
- Clinical presentation included cheek swelling, nasal hemorrhage, periorbital ecchymosis, and C-shaped nasal deviation.
- Neurological findings involved mild hypesthesia in the infraorbital nerve distribution.
- Key negative findings were absence of telecanthus, diplopia, ocular motility disorders, epiphora, trismus, and malocclusion.
Findings:
- Diagnosis was confirmed through clinical signs and imaging.
- One patient underwent surgical reduction of the medial maxillary fracture and concomitant injuries.
- The other patient opted against surgical intervention.
Implications:
- Emphasizes the need for careful differential diagnosis to distinguish medial maxillary fractures from similar injuries.
- Highlights the importance of considering concomitant fractures during treatment planning.
- Suggests a potential need for refining fracture classification systems to include medial maxillary fractures.
