Publication date: Available online 13 September 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Tae gon Kim, Bong gyu Choi, Jin Ho Lee, Kyu-Jin Chung, Jun Ho Lee, Yong-Ha Kim
Abstract
Background
Nasal and blowout fractures are the most common injuries due to craniomaxillofacial trauma. Nasal fractures are easily diagnosed by clinical signs such as pain and crepitus. However, blowout fractures are frequently asymptomatic and are easy to miss without computed tomography (CT) scan. This study was aimed at analyze the relationship between the two fractures to determine if nasal fracture can be used as a predictor of blowout fracture.
Methods
CT scans of 1368 patients who underwent reduction surgery of nasal fracture were retrospectively reviewed. The patterns of nasal fractures (n=1368) were classified as frontal or lateral type, according to the direction of impact. Blowout fractures (n=297) were classified into three types according to the position of the fractures: medial, inferior, and inferomedial wall. After calculating the number of patients in each group, the relationship between types of nasal and blowout fractures was statistically analyzed.
Results
Of 305 patients with frontal-type nasal fractures, the incidence of medial-, inferior-, and inferomedial-wall fractures was 26, 7, and 9, respectively. Of 1063 patients with lateral-type nasal fractures, the incidence of medial-, inferior-, and inferomedial-wall fractures was 118, 75, and 62, respectively. Medial-wall fracture was most common among both types of nasal fracture groups and is associated with a higher frequency in the lateral-type group.
Conclusions
This study revealed a strong relationship between nasal fractures and medial-wall blowout fractures. If nasal fracture is suspected, especially the lateral type, thorough examination for medial-wall blowout fracture, with a high index of suspicion.
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