Tratamento cirúrgico de fratura naso-órbito-etimoidal: uma revisão de literatura

Abstract

The anatomical region of the naso-orbito-ethmoidal complex (NOE) consists of an intricate articulation of several bony projections of the frontal, nasal, maxillary, lacrimal bones, vomer, ethmoid, palatal and sphenoid. It incorporates delicate noble structures such as the nasolacrimal drainage system and medial cantal ligaments. Naso-ethmoidal or naso-orbit- ethmoid fractures (NOE) represent less than 5 and 15% of facial fractures in adults and children, respectively. Despite the low incidence of NOE fractures, these are among the most challenging craniomaxillofacial fractures and inadequate treatment significantly affects the shape and function of the face. The high level of complexity of NOE type fractures, associated with a high rate of postoperative complications, are factors that have positioned this type of fracture in evidence in surgery and oral-maxillofacial trauma. The objective of this work is to review and discuss the literature about the treatment of NOE fractures. To make this possible, a search was performed in the PubMed database, using the keywords “ethmoid” and “fracture”, crossed with the Boolevarian “AND” operator for the past 10 years. 83 articles were found and, after reading the titles and abstracts, 15 articles were selected. In the selected articles, information was collected about the trauma etiology in the NOE region, the type of access and material used in the reconstruction and the use or not of cantopexies. In addition, the complications observed resulting from this surgical treatment were reported. In this work, the summary of this information brought that the coronary accesses was the most used (21%), as well as titanium meshes (36.8%) and transnasal cantopexies (75%) for the treatment of these fractures. However, it was very clear in this study that the literature lacks standardization of information on the subject, making data collection and a more in-depth assessment of this type of fracture extremely difficult.