NOE Type I fracture

Single large NOE fragment bearing the medial canthal tendon in unilateral Markowitz type I fractures.

The nasal bone is also frequently involved. In cases of comminution, it may not provide adequate dorsal support to the nasal bridge.

NOE fractures are often associated with frontal sinus fractures.

The nasoorbitoethmoid (NOE) fracture refers to injuries involving the area of confluence of the nose, orbit, ethmoids, the base of the frontal sinus, and the floor of the anterior cranial base. The area includes the insertion of the medial canthal tendon(s). NOE fractures, by definition, are a different entity to isolated nasal bone fractures as they extend medially to the bone bearing the medial canthal ligaments and the ethmoid sinuses. However, they are often associated with fractures of the nasal bones.

NOE fractures are most commonly classified as:

• Type I
• Type II
• Type III

These can be unilateral or bilateral injuries.

NOE complex fractures involve the upper portion of the medial vertical (nasomaxillary) buttresses of the facial skeleton. Click here for further details on buttresses.

This 3D CT scan shows a left unilateral NOE fracture in one complete piece with displacement. Other facial fractures are also visible.

There is some comminution of the nasal bones.