Abstract

The aim of this report is to provide a vision of the approaches used to resolve Nasal-Orbit-Ethmoidal (NOE) fractures, a purpose of two cases treated by two different types of approaches. The first case corresponds to a patient with a complex Nasal-Orbit-Ethmoidal fracture, treated by the use of pre- existing lacerations and with a transconjunctival approach with canthotomy and lateral extension, to access an orbital zygomatic fracture. The second case corresponds to a patient with Nasal-Orbit-Ethmoidal Fracture treated by the use of a conventional Coronal approach. Both cases were treated by the maxillofacial surgery team at Hospital El Carmen, Santiago Chile, and prior evaluation by Neurology, ophthalmology and anesthesiology was necessary due to the magnitude and extent of the trauma, ruling out neurological and ophthalmological compromise. Finally, it can be concluded from these cases that both, coronal approach and the use of prior lacerations are a viable alternative for access to the fractured area, obtaining good visibility, access and aesthetic results. We also conclude that fractures of the Nasal-Orbit-Ethmoidal complex are a great challenge for the maxillofacial surgeon due to its high morbidity, added to the aesthetic and psychological component associated with them and functional alterations. This is why the correct and timely management of these fractures is key to minimize complications and sequelae that they have.

Keywords

maxillofacial trauma, nasal, orbit-ethmoidal fractures, coronal approach, laceration, maxillofacial surgery, ophthalmological evaluation, coronal incision, orotracheal intubation