Isolated Fracture of Lateral Pterygoid Plate by Penetrating Foreign Body – A Rarity Indeed

BACKGROUND: Fractures of mid-face were first described by Le Fort and are classified into three categories – Le Fort I, Le Fort II and Le Fort III. The pterygoid processes of the sphenoid bone are fractured in all the three categories of Le Fort fractures as the sphenoid bone connects the cranium vault to the facial bones. Fractures of the pterygoid processes without associated Le Fort fractures are rare and are usually associated with fractures of the mandible, temporal bone or other facial bones. An isolated fracture of pterygoid plates without associated Le Fort fractures or fractures of other mid-face bones are exceedingly rare. CASE REPORT: We present a case of an isolated fracture of the right lateral pterygoid plate by a penetrating foreign body (wooden twig) in an adult male who presented with discharging sinus in the oropharynx. The presence of the foreign body was confirmed on computed tomography and was removed under general anesthesia via submandibular incision. The patient had an uneventful postoperative hospital stay and was asymptomatic on a follow-up five months later. CONCLUSIONS: This article emphasizes the fact that pterygoid plates may be fractured without an associated Le Fort fracture or a fracture of the mandible. This is the first case of an isolated pterygoid plate fracture in the literature.