Ver el código de «Naso-ethmoid fracture»

==Background==
*Also known as naso-orbito-ethmoid (NOE) fracture
*Results from high-energy direct impact to nasal bridge
*Involves the nasal bones, ethmoid sinuses, medial orbital walls, and frontal process of maxilla
*Medial canthal ligament (MCL) disruption is the key complication
*Associated intracranial injury in up to 70% of cases

==Clinical Features==
*Flattened nasal bridge, telecanthus (increased intercanthal distance >35mm)
*Periorbital ecchymosis, edema
*[[Epistaxis]]
*Epiphora (tearing) from lacrimal apparatus disruption
*CSF rhinorrhea if cribriform plate/dura involved
*'''Bowstring test:''' Pull lateral canthus laterally; if medial canthus moves freely, MCL is disrupted

==Differential Diagnosis==
{{Maxillofacial trauma DDX}}

==Evaluation==
*CT face with thin cuts through orbits and ethmoid — gold standard
*Bimanual palpation: hemostat intranasally while palpating medial orbital rim externally for crepitus
*Evaluate for CSF leak (halo test, beta-2 transferrin)
*Ophthalmology assessment for globe injury

==Management==
*'''Avoid nasotracheal intubation and NG tubes''' if cribriform plate disrupted
*Control [[epistaxis]] with anterior packing
*Antibiotics if open fracture or CSF leak
*Definitive repair by ENT/facial surgery (often delayed 5-7 days for edema)

==Disposition==
*Admit for associated injuries (intracranial, orbital)
*ENT/maxillofacial surgery and neurosurgery consults as indicated

==See Also==
*[[Nasal fracture]]
*[[Orbital fracture]]
*[[Le Fort fractures]]
*[[Basilar skull fracture]]

==References==
<references/>

[[Category:ENT]]
[[Category:Orthopedics]]
[[Category:Trauma]]