Naso EthmoidalOrbital Injuries

Suspect NEO injuries in those with trauma to the bridge of the nose or medial orbital wall ( Fig 24915). The mechanism of injury is usually dramatic, and these fractures are not likely due to fisticuffs. NEO fractures are frequently associated with lacrimal disruption and dural tears. Patients may complain of pain on eye movement, and physical examination may reveal traumatic telecanthus or epiphora (tears spilling over the lid).

p'1

FIG. 249-5. Schematic of midfacial fracture lines: Le Fort I, II, and III. (Reprinted with permission from Dingman RO, Natvig P: Surgery of Facial Fractures. Philadelphia, Saunders, 1964, p 248.)

If the medial canthus is tender, perform the intranasal palpation test and examine for CSF rhinorrhea. Plain radiographs are insensitive. 15 If the examination is suggestive, order a CT of the face to include coronal sections and thin axial slices through the medial orbital wall.

If an NEO fracture is present, consult a maxillofacial surgeon. As with many facial fractures, antibiotics are frequently prescribed for CSF leaks; however, no controlled studies have proven their efficacy. Some believe prophylactic antibiotics increase the risk of resistant organisms.

Spiritual Weight Loss Mentality

Spiritual Weight Loss Mentality

Awesome Ways To Get Over Your Mentality That Keeps you Overweight! This Book Is One Of The Most Valuable Resources In The World When It Comes To Results In Your Slim-down and Health Efforts! Day in day out we keep ourselves absorbed with those matters that matter the most to us. A lot of times, it might be just to survive and bring in some money. In doing so we at times disregard or forget about the extra matters that are essential to balance our lives. They’re even more essential to supply real meaning to our world. You have to pay attention to your wellness.

Get My Free Ebook


Post a comment