Fracture of the nasoethmoidal-frontal complex in East Paris
Maxillofacial Surgery Pr Meningaud
How is a fracture of the nasoethmoidal-frontal complex treated?
This is a centro-facial trauma involving the nasal pyramid, the walls of the frontal sinus and the perpendicular blade of the ethmoid. They are serious because they are associated with contusion of the frontal lobe, with the risk of dura mater breach and oculomotor disturbance.
Nasoethmoidal-Frontal complex fracture in East Paris
Maxillofacial surgeon Paris Est Créteil
How is a fracture of the nasoethmoidal-frontal complex treated?
Clinical presentation:
The picture associates a fracture of the bones proper of the nose with edema and effacement of the naso-frontal angle, a telecanthus (increased internal intercanthal distance), canthal dystopia and often subcutaneous emphysema due to fracture of a sinus wall.
Treatment :
operation under general anaesthetic with reduction of the telecanthus by internal canthopexy, treatment of fractures of the orbit and OPN, verification of the lacrimal tract. Fractures of the frontal sinus are treated by osteosynthesis, with control of fronto-nasal permeability.
If the posterior wall of the frontal sinus is involved, the sinus must either be excluded by filling with cancellous bone, or cranialised by removing the sinus and fixing the dura mater to the frontal bone. A period of neurosurgery may be required to close a dura mater breach.