整形６７

【臨床症状】70代　女性　転倒で顔面打撲

【問題】画像所見と診断名は？

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    ▶答えはこちら
    • 右鼻骨に骨折を認める
    • 眼窩吹き抜け骨折は認めない
    • 右鼻骨骨折と診断された

    【鼻骨骨折】

    ・鼻骨骨折は顔面骨骨折の中でも高頻度で、日常診療でもよく目にする

    ・主な症状は、外鼻変形、鼻出血、鼻塞など

    ・外鼻変形では、斜鼻型、鞍鼻型、混合型などがあり、斜鼻型が最も多いと言われている

    ・打撲等による顔面腫脹がある時は判別が難しい場合がある

    ・外鼻変形を伴わない骨折例もある

    ・若年者の男性に多く、原因はスポーツや交通事故、喧嘩など

    ・画像診断ではCTが有用性が高く、鼻骨骨折が明瞭に判別できる

    参考文献：板東伸幸, 石井秀幸, 金谷健史: 鼻骨骨折の臨床的検討. 耳鼻臨床 2000; 93: 361-366.
    　　　　　小川武則，鈴木直弘，沖津卓二，鼻骨骨折の臨床統計および画像診断，2002，耳鼻 臨床 95: 1; 51～61