PMC7426505_01
CT images showing multiple maxillofacial fractures affecting the maxillary and palatine bones (a,b green arrows), pterygoid hamulus (c red arrows), mandibular right condyle (d,e yellow arrows), and mandibular symphyseal separation (f,g green arrows).
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F1
Skull CT revealed bilateral maxillary and palatine fractures (Figures 1a,b), moderately displaced right eye exophthalmos and buphthalmos, bilateral fractures of pterygoid hamulus (Figure 1c), complete sagittal and comminuted fracture of the right mandibular condyle (Figures 1d,e), mandibular sympyseal separation (Figures 1f,g, 2A) and comminute fracture of the right tympanic bulla affecting its ventral aspect, which appeared partially collapsed with dorsal displacement of the fragments (Figures 2B, 3a).
CT three-dimensional reconstruction showing multiple maxillary fractures (A green arrows), mandibular symphyseal separation (A blue arrow) and comminute fracture of the right tympanic bulla (B red arrows).
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F2
Skull CT revealed bilateral maxillary and palatine fractures (Figures 1a,b), moderately displaced right eye exophthalmos and buphthalmos, bilateral fractures of pterygoid hamulus (Figure 1c), complete sagittal and comminuted fracture of the right mandibular condyle (Figures 1d,e), mandibular sympyseal separation (Figures 1f,g, 2A) and comminute fracture of the right tympanic bulla affecting its ventral aspect, which appeared partially collapsed with dorsal displacement of the fragments (Figures 2B, 3a).
Transverse plane CT images showing the right comminuted tympanic bulla fracture at initial presentation (a green arrows) and fracture healing observed 4 months after the diagnostic CT scan (b pink arrows).
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F3
Skull CT revealed bilateral maxillary and palatine fractures (Figures 1a,b), moderately displaced right eye exophthalmos and buphthalmos, bilateral fractures of pterygoid hamulus (Figure 1c), complete sagittal and comminuted fracture of the right mandibular condyle (Figures 1d,e), mandibular sympyseal separation (Figures 1f,g, 2A) and comminute fracture of the right tympanic bulla affecting its ventral aspect, which appeared partially collapsed with dorsal displacement of the fragments (Figures 2B, 3a). At this recheck, the maxillofacial fractures were noted to have healed properly, and the bony callus was present demonstrating fusion of the right tympanic bulla fragments (Figure 3b).
Ventro-dorsal and latero-lateral pre-operatory x-rays (A,B), inmediate post-operatory x-rays (C,D), and 5 weeks recheck x-rays after implant removal was performed (E,F).
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F4
The mandibular symphyseal separation was fixed using a single loop of 1.0 mm cerclage wire (Figures 4C,D). The patient was sedated again with the same protocol and x-ray images were performed demonstrating continued bone healing with callus formation of maxillary and mandibular fractures were observed, so cerclage wires and composite were removed (Figures 4E,F).