Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Mar;135(3):991-999.
doi: 10.1002/lary.31805. Epub 2024 Oct 18.

Outcomes of Surgical Repair of Adult Naso-Orbital-Ethmoid Fractures: A Systematic Review and Meta-Analysis

Keith R Conti  1 , Akash M Bhat  2   3 , Shaun A Nguyen  2 , Rhonda Rohloff  1 , Jarrod A Keeler  1   4
Affiliations
Meta-Analysis

Outcomes of Surgical Repair of Adult Naso-Orbital-Ethmoid Fractures: A Systematic Review and Meta-Analysis

Keith R Conti et al. Laryngoscope. 2025 Mar.

Abstract

Objectives: Adult naso-orbital-ethmoid (NOE) fractures are estimated to account for 5% of all adult facial fractures without published consensus on management. The purpose of this investigation was to assess the available literature regarding the treatment and outcomes of adult naso-orbital-ethmoid fractures.

Data sources: Cochrane Library, PubMed, Scopus, and CINAHL.

Methods: Following PRISMA guidelines, databases were searched from inception through July 25, 2024 for studies pertaining to the treatment of NOE fractures. Measures of interest included patient demographics, associated fractures, type of intervention, and complications.

Results: A total of 16 studies were included for meta-analysis, consisting of 459 patients. The patients included in the analysis had a mean age of 30.6 years (95% CI: 26.9-34.3 years) with a male-to-female gender ratio of 2.7:1. Operative intervention, specifically open reduction and internal fixation (ORIF) (90.1%; 95: CI: 76.6-98.1%), was the most commonly performed management. Closed reduction has been reported for all three types. The most frequently reported complications included nasolacrimal duct obstruction (38.6%; 95% CI: 10.6-71.7%), postoperative epiphora (24.9%; 95% CI: 6.4-50.4%), and telecanthus (20.9%; 95% CI: 1.7-53.5%).

Conclusions: Surgical intervention can be considered for all NOE types. Despite surgical intervention, NOE fractures remain difficult to treat, and inadequate repair may result in complications. Laryngoscope, 135:991-999, 2025.

Keywords: adult; facial fracture; fracture; nasoorbitalethmoid; naso‐orbital‐ethmoid.

PubMed Disclaimer

References

BIBLIOGRAPHY

    1. Kelley P, Crawford M, Higuera S, Hollier LH. Two hundred ninety‐four consecutive facial fractures in an urban trauma center: lessons learned. Plast Reconstr Surg. 2005;116(3):42e‐49e. https://doi.org/10.1097/01.prs.0000177687.83247.27.
    1. Nguyen M, Koshy JC, Hollier LH Jr. Pearls of nasoorbitoethmoid trauma management. Semin Plast Surg. 2010;24(4):383‐388. https://doi.org/10.1055/s-0030-1269767.
    1. Alves LS, Aragao I, Sousa MJ, Gomes E. Pattern of maxillofacial fractures in severe multiple trauma patients: a 7‐year prospective study. Braz Dent J. 2014;25(6):561‐564. https://doi.org/10.1590/0103-6440201302395.
    1. Wusiman P, Maimaitituerxun B, Guli, Saimaiti A, Moming A. Epidemiology and pattern of Oral and maxillofacial trauma. J Craniofac Surg. 2020;31(5):e517‐e520. https://doi.org/10.1097/SCS.0000000000006719.
    1. Follmar KE, Baccarani A, Das RR, Erdmann D, Marcus JR, Mukundan S. A clinically applicable reporting system for the diagnosis of facial fractures. Int J Oral Maxillofac Surg. 2007;36(7):593‐600. https://doi.org/10.1016/j.ijom.2007.03.010.

LinkOut - more resources