Late sequelae after high midface trauma

The upper midface area comprises mainly the naso-orbito-ethmoidaI (NOE) reg ion which plays a paramount role in facial expression. Fractures of this ar ea often result in neglected bony defects in the fragile periorbital region with major secondary impairments such as traumatic telecanthus, orbital dy stopia, and/or enophthalmos, Permanent cranial nerve deficits also can occu r as the result of post-traumatic/post-operative sequelae, Seventy-one pati ents (age range 7-78 years) with severe high midface trauma, treated from J anuary 1989 to December 1996, were reviewed with a minimum follow-up of 2 y ears. The patient population has been distributed according to the fracture type in three groups: Group I (n=35): Isolated NOE with/without associated central midface injury; Group 2 (n=22): NOE associated with craniofacial i njury and Group 3 (n=14): NOE associated with orbital displacement. The est imated post-surgical parameters included qualitative and quantitative data from the long-term clinical evaluation. Persistent headache and/or concentr ation difficulties were mainly noted in Group 1, Smell reduction or anosmia was reported mainly in Group 2, Deficits of the trigeminal and/or the faci al nerve were found in Group 3, Enophthalmos and/or telecanthus were predom inantly seen with injuries associated with orbital displacement.