Trauma of the upper third of the face. Management and follow-up

Of 407 patients with facial fractures who were operated on at the Department of Oral and Maxillo-Facial Surgery, University Hospital, Nijmegen, over a 3-year period, 23 had a fracture in the nasofrontal region with or without extension to the base of the skull. The problems and results of the treatment of these fractures are presented, with special reference to the management of the frontal sinus lesions, the lacrimal system, and the reconstruction of the nasal skeleton and canthal attachments. The postoperative complications and sequellae are discussed. Most prominent features are ocular problems and unsatisfactory nasal contour. Conclusions which could contribute to the proper therapeutic management are drawn.