Nasoethmoid orbital fractures: diagnosis and management.
OBJECTIVE
Trauma to the central midface may result in complex nasoethmoid orbital fractures. Due to the intricate anatomy of the region, these challenging fractures may often be misdiagnosed or inadequately treated. The purpose of this article is to aid in determining the appropriate exposure and method of fixation.


METHODS
This article presents an organized approach to the management of nasoethmoid orbital fractures that emphasizes early diagnosis and identifies the extent and type of fracture pattern. It reviews the anatomy and diagnostic procedures and presents a classification system. The diagnosis of a nasoethmoid orbital fracture is confirmed by physical examination and CT scans. Fractures without any movement on examination or displacement of the NOE complex on the CT scan do not require surgical repair. Four clinical cases serve to illustrate the surgical management of nasoethmoid fractures.


CONCLUSIONS
Early treatment using aggressive techniques of craniofacial surgery, including reduction of the soft tissue in the medial canthal area and restoration of normal nasal contour, will optimize results and minimize the late post-traumatic deformity. A high index of suspicion in all patients with midfacial trauma avoids delays in diagnosis.
Sargent
L A
LA
Department of Plastic Surgery, University of Tennessee, 979 East Third Street, Suite 900, Chattanooga, TN 37403, USA.
Rogers
G F
GF
D000368:Aged; D016025:Bone Transplantation; D005004:Ethmoid Bone / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D005143:Eyelids / Q000293:injuries; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D018460:Fractures, Comminuted / Q000175:diagnosis / Q000601:surgery; D005626:Frontal Sinus / Q000293:injuries; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery; D022125:Lacerations / Q000601:surgery; D008297:Male; D009666:Nose / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D009915:Orbit / Q000473:pathology; D009917:Orbital Fractures / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D010808:Physical Examination; D012887:Skull Fractures / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed