Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Showa-machi, Maebashi City, Gunma, Japan.
Medicine (Baltimore). 2022 Nov 18;101(46):e31845. doi: 10.1097/MD.0000000000031845.
Medial maxillary fractures are defined as fractures of the medial aspect of the maxilla, that is, fractures of the nasomaxillary buttress. The diagnosis of medial maxillary (nasomaxillary buttress) fractures is challenging because of its similarities with nasal, and naso-orbito-ethmoidal (NOE) fractures.
The patients included a 17-year-old Japanese man and a 37-year-old Japanese woman with facial injuries. Swelling of the affected cheek, nasal hemorrhage, periorbital ecchymosis, and C-shaped deviation of the nasal dorsum with normal nasal tip and root position were observed. Mild hypesthesia was noted in the affected region innervated by the left infraorbital nerve. Telecanthus, double vision, eye movement disorder, epiphora, trismus, tooth fracture, and malocclusion were absent in both cases.
Based on clinical signs and imaging findings, the patients were diagnosed with medial maxillary (nasomaxillary buttress) fracture.
The 17-year-old man underwent a reduction of the medial aspect of the maxillary bone with the treatment of concomitant fractures, and the 37-year-old woman did not request treatment.
Medial maxillary (nasomaxillary buttress) fractures are not included in any current classification of the maxillary fracture patterns. As medial maxillary (nasomaxillary buttress) fractures are similar to nasal, and NOE fractures, careful differential diagnosis is required before selecting the surgical procedure to be performed because the treatment of concomitant fractures is also necessary.
上颌骨内侧骨折是指上颌骨内侧的骨折，即鼻上颌骨支柱骨折。由于其与鼻骨和鼻眶额筛（NOE）骨折相似，因此诊断上颌骨内侧（鼻上颌骨支柱）骨折具有挑战性。
患者包括一名 17 岁的日本男性和一名 37 岁的日本女性，均有面部受伤。观察到受累侧脸颊肿胀、鼻出血、眶周瘀斑和 C 形鼻背偏斜，鼻尖和根部位置正常。左侧眶下神经支配区域有轻度感觉减退。在这两种情况下，均未出现内眦距离增宽、复视、眼球运动障碍、溢泪、牙关紧闭、牙齿骨折和咬合不正。
根据临床体征和影像学结果，诊断为上颌骨内侧（鼻上颌骨支柱）骨折。
17 岁男性接受了上颌骨内侧骨折的复位治疗，同时治疗了合并骨折；37 岁女性未要求治疗。
目前的上颌骨骨折类型分类中不包括上颌骨内侧（鼻上颌骨支柱）骨折。由于上颌骨内侧（鼻上颌骨支柱）骨折与鼻骨和 NOE 骨折相似，因此在选择要进行的手术程序之前需要仔细进行鉴别诊断，因为也需要治疗合并骨折。
