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Late sequelae after high midface trauma.

N D Kalavrezos1, K W Graetz, G K Eyrich

  • 1Department of Maxillofacial Surgery, University Hospital Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.

Journal of the Royal College of Surgeons of Edinburgh
|January 12, 2001
PubMed
Summary

Severe midface trauma, particularly naso-orbito-ethmoidal (NOE) fractures, can lead to lasting impairments. Treatment outcomes vary based on fracture type, affecting facial expression and nerve function.

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Neurosurgery

Background:

  • The naso-orbito-ethmoidal (NOE) region is crucial for facial expression.
  • NOE fractures often cause neglected bony defects and secondary impairments like telecanthus, orbital dystopia, and enophthalmos.
  • Permanent cranial nerve deficits can arise from trauma or surgery.

Purpose of the Study:

  • To analyze the long-term clinical outcomes of severe high midface trauma involving the NOE region.
  • To correlate specific fracture types with distinct post-surgical sequelae.

Main Methods:

  • A retrospective review of 71 patients with severe high midface trauma treated between 1989 and 1996.
  • Patients were categorized into three groups based on fracture type: isolated NOE, NOE with craniofacial injury, and NOE with orbital displacement.

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  • Minimum follow-up of 2 years with qualitative and quantitative clinical evaluation.

    • Main Results:

    • Group 1 (isolated NOE) patients mainly experienced persistent headache and concentration difficulties.
    • Group 2 (NOE with craniofacial injury) patients predominantly reported reduced smell or anosmia.
    • Group 3 (NOE with orbital displacement) patients showed trigeminal and/or facial nerve deficits, with enophthalmos and telecanthus being common.

    Conclusions:

    • The type of naso-orbito-ethmoidal fracture significantly influences the pattern of long-term post-surgical deficits.
    • Understanding these correlations aids in predicting and managing outcomes for patients with severe midface trauma.