title: Aesthetic management of the nasal component of naso-orbital ethmoid fractures.
abstract: OBJECTIVE
  After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nasal reconstruction. 4. List the techniques used in aesthetic reconstruction of the nose in naso-orbital ethmoid fractures.
  
  
  BACKGROUND
  Fractures of the naso-orbital ethmoid complex pose challenging management issues. Although basic treatment principles have been well described, the aesthetic management of the nasal component has not been adequately addressed in the literature.
  
  
  METHODS
  When secondary nasal deformities occur, they are difficult to correct. Optimal primary correction of the nasal deformity is accomplished using the following four principles: (1) rigid fixation of the nasal pyramid and restoration of nasal height and length; (2) restoration of tip projection; (3) septal reduction/reconstruction; and (4) lateral nasal wall augmentation.
  
  
  RESULTS
  Successful management of naso-orbital ethmoid fractures is a complex and challenging task. Both the bony and soft-tissue components must be addressed and the extent of the injury must be adequately diagnosed to avoid omission of critical steps in the reconstruction. Inadequate treatment of naso-orbital ethmoid fractures can produce a severe cosmetic deformity that is very difficult to correct secondarily.
  
  
  CONCLUSIONS
  The authors discuss the nasal component of naso-orbital ethmoid complex injuries and detail the key principles in their algorithm for aesthetic nasal reconstruction.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas 75390-9132, USA.
authors.forename: Jason K
authors.initials: JK
authors.lastname: Potter
authors.forename: Arshad R
authors.initials: AR
authors.lastname: Muzaffar
authors.forename: Edward
authors.initials: E
authors.lastname: Ellis
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
authors.forename: Fred L
authors.initials: FL
authors.lastname: Hackney
mesh_terms: D000465:Algorithms; D004954:Esthetics; D005004:Ethmoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D009300:Nasal Septum / Q000601:surgery; D009667:Nose Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D014057:Tomography, X-Ray Computed