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Nasoorbitoethmoid fractures in the pediatric population
Zhazira Irgebay, BA; Erin E. Anstadt, MD; Jesse A. Goldstein, MD; Joseph E. Losee, MD
University of Pittsburgh
2022-01-31
Presenter: Zhazira Irgebay
Affidavit:
This student was responsible for over half of the conception, design, data collection, analysis of data, and abstract drafting for this project.
Director Name: Vu T Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Nasoorbitoethmoid (NOE) fractures in the pediatric population has been poorly characterized. This study's purpose is to describe single institution experience with management of pediatric nasoorbitoethmoid fractures.
Methods: We performed a retrospective review of pediatric patients who presented with nasoorbitoethmoid fractures to a level I trauma center between 2005 to 2021. Variables included age, admission status, associated facial fractures, operative vs conservative treatment, and associated injuries.
Results: Sixty-five patients met our inclusion criteria. Fifty (75.8%) of the patients were male. Average age was 12.5 +/- 3.6. The most common causes of injuries were motor vehicle accidents (n = 25, 37.9%) and sports (n = 21, 31.8%). Fourteen patients arrived as level I trauma (21.2%) and 11 patients were intubated (16.7%). Average lowest GCS score was 13.1 +/- 3.9. Forty-seven of the patients were admitted (71.2%), with 25 patients admitted to the ICU (37.9%). Forty-six patients underwent operative management (69.7%). The most common associated facial fractures were orbital (n=61, 92.4%) and maxillary (n=54, 81.8%). The most common associated injuries with NOE fractures were soft tissue (n = 55, 83.3%), neurologic (n = 39, 59.1%) and ophthalmologic injuries (n=28, 42.4%).
Conclusions: Nasoorbitoethemoid fractures represent a small portion of pediatric facial fractures, often due to a forceful traumatic event. Due to their complexity, they are associated with significant traumatic comorbidities, which could require multidisciplinary management and a complicated hospital course.
