Management of Injuries of the Naso-orbital Complex

Fractures of the naso-orbital bony complex and injuries of the adjacent soft tissues usually occur as a result of a direct force to the dorsum of the nose. The displacement of the bones of the nasal skeletal framework into the interorbital space may produce severe and sometimes life threatening injury. This type of injury results in severe cosmetic and functional deformity due to collapse of the nasal structures and interruption of attachment of the medial palpebral ligaments. These injuries frequently result in epiphora secondary to interference with the physiology or continuity of the lacrimal drainage apparatus. Injuries to this area may endanger the patient's life because of associated fractures of the floor of the anterior cranial fossa or the posterior wall of the frontal sinus. Concomitant dural tears, cerebrospinal fluid rhinorrhea, and brain injury may be noted.

Successful management of these injuries requires careful replacement and reconstruction of all damaged