0:01

Let's look at another NOE fracture. So, N for nasal bones,

0:07

and we see that they are fractured. And Nalso for the

0:11

nasofrontal or nasal maxillary sutures that may

0:14

be involved. O for the orbital involvement.

0:17

Here we see the medial orbital wall fracture with a fragment

0:21

along that medial canthal ligament, which is seen right

0:24

along here, and that's involved on the left side.

0:28

The O may also involve the nasolacrimal duct. In this case,

0:33

although the reconstructions are not that great,

0:36

it does look like that duct is intact.

0:39

The E is the ethmoidal, and that's usually the superior

0:42

fragment here that goes across the top of the ethmoid sinus.

0:47

And you can see a comminuted fracture here that is involving

0:51

both the frontal sinus, as well as the anterior ethmoid sinus

0:55

and therefore may be potentially involved at the frontal

0:59

ethmoidal recess or nasofrontal duct.

1:02

Notice that this, again, looks like it's comminuted

1:05

and displaced inward this central fragment.

1:08

When we look at it on the coronal reconstruction, you can

1:11

see the plane of the fracture across the top of the ethmoid

1:16

bone. Here's the perpendicular plate of the ethmoid bone.

1:18

And this is going from right to left involving the medial

1:23

orbital wall, which is typical of NOE fractures.

1:27

When we look at the lacrimal duct here and the lacrimal

1:30

duct here, not too bad.

1:32

Those look like they are intact.

1:36

But this big segment here is a large fracture fragment

1:41

that shows some element of comminution.

1:44

Let's take a quick look at the 3D reconstruction, and you can

1:49

see the plane of the fracture here

1:52

and the orbital floor fractures.

1:54

This is like a little mid-face buttress

1:58

large fracture fragment that may be floating and requires

2:03

usually immediate surgical intervention.

Case: Midface NOE Fracture

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