Nasoethmoid Fractures Workup

Updated: Nov 01, 2018
  • Author: David W Kim, MD; Chief Editor: Deepak Narayan, MD, FRCS  more...
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Workup

Imaging Studies

Generally, plain radiograph and CT scan images are taken of all patients with possible facial fractures. [6, 7] Plain radiographs have limited utility in assessing isolated nasoethmoid fractures. These films may demonstrate opacification or clouding of the maxillary and ethmoid sinuses, indicating the presence of blood. They also may show larger associated facial fractures but are unlikely to characterize the relatively detailed osseous anatomy of the NOE complex. Therefore, CT scan images have replaced plain films as the main imaging tool to assist in the diagnosis and treatment planning for NOE fractures.

CT scan images have superior resolution compared to plain films. They are also better for helping delineate multiple fractures, evaluate associated cartilaginous or soft tissue injury, evaluate brain involvement, and assess for the presence of impingement into the optic canal. Thin (2-mm or less) cuts in both the coronal and axial planes are needed to obtain adequate detail of fractures. [1]

More recently, the use of three-dimensional CT scan imaging and computer modeling allow reconstruction of facial symmetry in a virtual environment. [8]