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Naso-ethmoid-orbital fractures

C W Cruse, P K Blevins, E A Luce

    The Journal of Trauma
    |July 1, 1980
    PubMed
    Summary

    Naso-ethmoid-orbital fractures often result from motor vehicle accidents and commonly involve other facial injuries. Open reduction and internal fixation significantly improve outcomes for these complex injuries.

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    Area of Science:

    • Trauma Surgery
    • Ophthalmology
    • Neurosurgery
    • Plastic Surgery

    Background:

    • Naso-ethmoid-orbital (NEO) fractures are complex injuries often associated with significant facial trauma.
    • Previous literature has not adequately emphasized the severity and potential sequelae of these fractures.
    • Understanding the patterns of injury and outcomes is crucial for effective management.

    Purpose of the Study:

    • To review the experience with naso-ethmoid-orbital fractures at a major medical center.
    • To define diagnostic and therapeutic guidelines based on clinical experience.
    • To highlight the importance of a multidisciplinary approach.

    Main Methods:

    • Retrospective review of 33 patients with naso-ethmoid-orbital fractures treated between October 1976 and January 1979.
    • Analysis of injury mechanisms, associated injuries, clinical findings, and treatment outcomes.
    • Evaluation of diagnostic criteria and surgical techniques.

    Main Results:

    • The majority of injuries resulted from motor vehicle accidents, with 60% experiencing associated nonfacial injuries.
    • Commonly associated injuries included orbital rim/floor fractures (94%), complex maxillary fractures (72%), and mandible fractures (25%).
    • High incidence of traumatic telecanthus (70%), cerebrospinal fluid rhinorrhea (40%), and severe ocular injury (30%) with vision loss.

    Conclusions:

    • Naso-ethmoid-orbital fractures are severe injuries with a high risk of deformity, dysfunction, and vision loss.
    • Open reduction and internal fixation yielded vastly improved results.
    • A mandatory multidisciplinary approach involving neurosurgery, ophthalmology, and plastic surgery is essential for optimal patient care.

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