Simplified Transnasal Canthal Fixation of Naso-orbito-ethmoidal Fractures

Area of Science:

• Maxillofacial surgery
• Trauma surgery
• Ophthalmology

Background:

• Naso-orbito-ethmoidal (NOE) fractures represent 9-10% of facial fractures, predominantly affecting young males.
• These fractures involve complex anatomical structures including sinuses, cranial fossa, orbits, and facial bones.
• The Markowitz and Manson classification (1991) categorizes NOE fractures based on bone fragment status, medial canthal tendon position, and laterality.

Observation:

• Traumatic telecanthus and nasolacrimal duct obstruction are frequent complications of NOE fractures.
• A case of bilateral NOE type II fracture presented with traumatic telecanthus and nasal dorsum deformity.
• The authors employed transnasal canthal fixation using nonabsorbable sutures and a 1-mL syringe plunger for support.

Findings:

• The transnasal canthal fixation successfully corrected traumatic telecanthus.
• Nasal dorsum projection was restored, improving both functional and aesthetic outcomes.
• The technique proved simple, reproducible, and utilized readily available materials.

Implications:

• Transnasal canthal fixation offers a minimally invasive approach for managing complex NOE fractures.
• This technique reduces operative time and avoids the need for specialized equipment.
• The procedure yields favorable aesthetic results and minimizes complications, enhancing patient recovery.