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Management of Nasoorbitoethmoidal Fracture: An Institutional Experience

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The nasoorbitoethmoidal fractures remain the most complex of all facial fractures to diagnose and treat mainly because of the intricate anatomy and difficulty in fracture fixation. The number of such fractures are increasing with the more incidence of high-speed, high-force accidents. The nasoorbitoethmoidal fractures rarely occur as an isolated event. Associated injuries often include central nervous system injuries, cribriform plate fracture, cerebrospinal fluid rhinorrhea, and fractures of the frontal bone, orbital floor, and middle third of the face as well as injury to the lacrimal system. The appropriate management of these injuries require an understanding of the anatomic features of the region, the degree of severity of damage. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Twenty-four patients who suffered The nasoorbitoethmoidal fractures with/without associated multiple midfacial injuries were included in the study. Postoperatively, results show stable symmetrical fixation of the canthus in three dimensions with good apposition of the eyelids against the ocular globe along with acceptable nasofrontal angle and nasal prominence. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.

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References

  1. Frost DE, Kendell BD (1991) Chapter 12: Applied surgical anatomy of the head and neck. In: Fonseca RJ, Walker RV (eds) Oral and maxillofacial trauma. W B Saunders Company, Philadelphia, pp 226–233

    Google Scholar 

  2. Stranc MF (1970) Primary treatment of naso-ethmoid injury with increased intercanthal distance. Br J Plast Surg 23:8

    Article  CAS  PubMed  Google Scholar 

  3. Markowitz BL, Manson PN, Sargent L, Kolk CAV, Yaremchuk M, Glassman D et al (1991) Management of the medial canthal tendon in nasoethmoid orbital fractures: the importance of the central fragment in classification and treatment. Plast Reconstr Surg 87:843–853

    Article  CAS  PubMed  Google Scholar 

  4. Callahan A (1963) Secondary reattachment of the medial canthal ligament. Arch Ophthamol 70:240

    Article  CAS  Google Scholar 

  5. Jack J (1986) Aids to human osteology. Bailliere Tindall WB Saunders, Philadelphia, pp 161–193

    Google Scholar 

  6. Callahan A, Callahan MA (1983) Fixation of the medial canthal structures: evolution of the best method. Ann Plast Surg 11:212

    Article  Google Scholar 

  7. Shore JW, Rubin PA, Bilyk JR (1992) Repair of telecanthus by anterior fixation of cantilevered miniplates. Ophthalmology 99:1133–1138

    Article  CAS  PubMed  Google Scholar 

  8. Banks P (ed) (1987) Killey’s fractures of the middle third of the facial skeleton. Butterworth and Company Ltd., Kent, England, pp 3–60

    Google Scholar 

  9. Manson PN, Hoopes JE, Su CT (1980) Structural pillars of the facial skeleton: an approach to the management of Le Fort fractures. Plast Reconstr Surg 66(54–62):4

    Google Scholar 

  10. Haskell R (1994) Chapter 1: Applied surgical anatomy. In: Williams JL (ed) Rowe and Williams maxillofacial injuries. Churchill Livingstone, London, pp 19–23

    Google Scholar 

  11. Mustarde JC (1964) Epicanthus and telecanthus. Int Ophtholmol Clin 4:59–76

    Google Scholar 

  12. Dingman RO, Grabb WC, Oneal RM (1969) Management of injuries of naso-orbital complex. Arch Surg 98:566–571. https://doi.org/10.1001/archsurg.1969.01340110058003

    Article  CAS  PubMed  Google Scholar 

  13. Priel A, Leelapatranurak K, Oh S, Korn BS, Kikkawa DO (2011) Medial canthal degloving injuries: the triad oftelecanthus, ptosis, and lacrimal trauma. Plast Reconstr Surg 128:300e

    Article  CAS  PubMed  Google Scholar 

  14. Mathog RH, Bauer W (1979) Posttraumatic pseudohypertelorism (Telecanthus). Arch Otolaryngol 105(2):81–85

    Article  CAS  PubMed  Google Scholar 

  15. Stoll P, SchiIli W, Joos U (1983) The stabilization of midface-fractures in the vertical dimension. J Maxillofac Surg 11(1983):248–251

    Article  CAS  PubMed  Google Scholar 

  16. Marschall MA, Cohen M, Garcia J, Schafer ME (1988) Craniofacial approach for the reconstruction of severe facial injuries. J Oral Maxillofac Surg 46:305–310. https://doi.org/10.1016/0278-2391(88)90014-6

    Article  CAS  PubMed  Google Scholar 

  17. Abubaker AO et al (1990) Modified Le Fort I (maxillary-zygomatic) osteotomy: rationale, basis, and surgical technique. J Oral Maxillofac Surg 49(10):1089–1097

    Article  Google Scholar 

  18. Wittkampf AR, Mourits MP (2001) A simple metod for medial canthal reconstruction. Int J Oral Maxillofac Surg 30:342–343

    Article  CAS  PubMed  Google Scholar 

  19. Abubaker A, Sotereanos G, Patterson GT (1990) Use of the coronal surgical incision for reconstruction of severe craniofacial injuries. J Oral Maxillofac Surg 48:578–586

    Google Scholar 

  20. McIndoe AH (1941) Diagnosis and treatment of injuries of the middle third of the face. Braz Dent J 71:235

    Google Scholar 

  21. Frodel JL, Marentette LJ (1993) The coronal approach: anatomic and technical considerations and morbidity. Arch Otolaryngol-Head Neck Surg 119:201–207. https://doi.org/10.1001/archotol.1993.01880140091014

    Article  CAS  PubMed  Google Scholar 

  22. Blair VP, Brown JP, Hamm WG (1932) Surgery of the innercanthus and related structures. Am J Ophthalmol 15:498

    Article  Google Scholar 

  23. Harry P, Nader KS (2009) Management of Naso-Orbital—Ethmoidal Fractures. Oral Maxillofac Surg Clin N Am 21:221–225

    Article  Google Scholar 

  24. Gruss JS, Hurwitz JJ, Nik NA et al (1985) The pattern and incidence of nasolacrimal injury in naso-orbitalethmoid fractures: the role of delayed assessment and dacryocystorhinostomy. Br J Plast Surg 38:116

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Sucharu Ghosh.

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The authors do not have any financial or personal relationship with any other person or organisation that could inappropriately influence (bias) this work.

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Banerjee, R., Basu, S., Pachisia, S. et al. Management of Nasoorbitoethmoidal Fracture: An Institutional Experience. Indian J Otolaryngol Head Neck Surg 71, 225–232 (2019). https://doi.org/10.1007/s12070-018-1473-6

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  • DOI: https://doi.org/10.1007/s12070-018-1473-6

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