Simplified Transnasal Canthal Fixation of Naso-orbito-ethmoidal Fractures

The naso-orbito-ethmoidal (NOE) region is formed by the confluence of the frontal sinuses, ethmoidal sinuses, anterior cranial fossa, orbits, and frontal and nasal bones. Fractures involving this area correspond to 9%-10% of facial fractures, with a higher prevalence in male patients between 20 and 30 years of age. In 1991, Dr. Markowitz and Dr. Manson classified these types of fractures based on the following characteristics: the state of the central bone fragments, the position of the medial canthal tendon, and whether they are unilateral or bilateral fractures. NOE fractures can be associated with a number of complications, with traumatic telecanthus and nasolacrimal duct obstruction being the most frequent complications. The authors report a case of a bilateral NOE type II fracture, in which transnasal canthal fixation was performed using nonabsorbable sutures and the support base of a 1-mL syringe plunger, for the correction of traumatic telecanthus and restoration of the nasal dorsum projection. Transnasal canthal fixation is a simple and reproducible technique that reduces operative time and uses frequently used materials without the need for additional equipment. This technique not only presents few complications but also offers aesthetic results by improving traumatic telecanthus while restoring nasal dorsum projection.