Naso-orbitoethmoid (NOE) complex fracture

Naso-orbitoethmoid (NOE) fractures (also known as orbitoethmoid or nasoethmoidal complex fractures) are fractures which involve the central upper midface.

Naso-orbitoethmoid fractures are caused by a high-impact force applied anteriorly to the nose and transmitted posteriorly through the ethmoid bone.

Associated injuries include:

Comminution of both medial maxillary buttresses results in a pattern of fractures involving the nasal bones and septum, ethmoid sinuses, and medial orbital walls.

The Markowitz and Manson classification system categorizes fractures of the NOE complex as follows 3:

  • type I: in which the medial canthal tendon is intact and connected to a single large fracture fragment
  • type II: the fracture is comminuted, and the medial canthal tendon is attached to a single bone fragment
  • type III: comminution extends to the medial canthal tendon insertion site on the anterior medial orbital wall at the level of the lacrimal fossa, with resultant avulsion of the tendon

Article information

rID: 30908
Synonyms or Alternate Spellings:
  • NOE complex fractures
  • Nasoethmoidal complex fractures
  • Orbitoethmoid fractures

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Cases and figures

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