What happens if Cribriform plate damage?

Fractures of the cribriform plate can be associated with septal hematoma, olfactory dysfunction, cerebral spinal fluid leak, or infection, which can progress to meningitis.

What is an NOE fracture?

The nasoorbitoethmoidal (NOE) fracture refers to injuries involving the area of confluence of the nose, orbit, ethmoids, the base of the frontal sinus, and the floor of the anterior cranial base. The area includes the insertion of the medial canthal tendon(s).

What is tripod fracture?

The zygomaticomaxillary complex fracture, also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture, has four components, three of which are directly related to connections between the zygoma and the face, and the fourth being an orbital blowout.

What is a nasal orbital ethmoid fracture?

Naso-orbito-ethmoidal (NOE) fractures are complicated fractures of mid-face structure which include nasal, lacrimal, maxillary, frontal, and ethmoid bones. The central feature of NOE fracture is displacement of the medial orbital rim with the medial canthal ligament attached.

What nerve is for smell?

The olfactory nerves (I) are special sensory nerves for the sense of smell. They originate in the receptors of the olfactory epithelium and pass through the olfactory foramina in the cribriform plate of the ethmoid bone, ending at the olfactory bulbs.

What is Panfacial fracture?

Panfacial bone fractures are defined as facial fractures simultaneously involving the upper, middle, and lower thirds of the face. Fractures of the frontal bone, maxilla, zygomatic complex, nasoethmoid-orbital (NEO) region, and mandible are the most common [1,2,3].

What are the different types of nasal bone fracture?

Nasal bone fractures were classified into six types: Type I) Simple without displacement; Type II) Simple with displacement/without telescoping; IIA; Unilateral; IIAs) Unilateral with septal fracture; IIB) Bilateral; IIBs) Bilateral with septal fracture; Type III) Comminuted with telescoping or depression.

What is the most common facial fracture?

Nasal bones (broken nose): Nasal bone fractures are the most common type of facial fracture. The nasal bone is made up of two thin bones. It takes less force to break the nasal bones than other facial bones because they are thin and prominent.

What Happens When the ethmoid bone is fractured?

The ethmoid fracture can produce bone fragments that penetrate the cribriform plate. This trauma can lead to a leak of cerebrospinal fluid into the nasal cavity. These openings let opportunistic bacteria in the nasal cavity enter the sterile environment of the central nervous system (CNS).

Why are there so many holes in the cribriform plate?

Function. The cribriform plate is perforated by olfactory foramina, which allow for the passage of the olfactory nerves to the roof of the nasal cavity. This conveys information from smell receptors to the brain.

What are the types of nasoorbitoethmoid fractures?

Type II fractures involve comminution of the central fragment, but the medial canthal tendon remains firmly attached to a definable segment of bone. Type III fractures are uncommon and result in severe central fragment comminution with disruption of the medial canthal tendon insertion.

How to diagnose a nasoethmoid facial fracture?

Frequently frontal sinus fractures accompany severe nasoethmoid fractures. Head and neck trauma exam with special attention to: 1. Bony contour of the forehead and root of the nose, check for any step off’s. 2. Careful ocular exam with special attention to globe position, diplopia and extraocular movements. 3. Measure the intercanthal distance.

When to use a nasoethmoid fracture operative plan?

If an associated frontal sinus fracture is present, the operative plan should include the definitive repair of this fracture in conjunction with the nasoethmoid fracture (see frontal sinus fracture management below).

What are the long term sequelae of NOE fractures?

Long-term sequelae of NOE fractures include blindness, telecanthus, enophthalmos, midface retrusion, cerebral spinal fluid (CSF) fistula, anosmia, epiphora, sinusitis, and nasal deformity. Accurate diagnosis and prompt surgical treatment of NOE fractures are critical to avoid complications and to obtain an aesthetic surgical result.