Unilateral isolated fracture of the pterygoid plate: a case report

Pterygoid plate fractures are often associated with Le Fort fractures and accompanied by other facial fractures such as frontal sinus and naso-orbital-ethmoid fractures; isolated pterygoid plate fractures are extremely rare. Le Fort fractures must be surgically treated with fixation of unstable fracture segments to re-establish bone form and function, and the pterygoid process must be surgically stabilized; however, surgical treatment is unnecessary in isolated pterygoid plate fractures. Here, we report a rare case of isolated unilateral fracture of the pterygoid process in a 71-year-old female patient who had a syncopal episode with secondary head injury and a hematoma at the base of the right orbit. A computed tomography scan showed unilateral right pterygoid plate fracture with signs of emphysema in the ipsilateral masticatory space. The patient also had a fracture of the medial wall of the right maxillary sinus with hemosine, but no fractures of the skull base or theca. She was treated conservatively.