Management of the Medial Canthal Tendon in Nasoethmoid Orbital Fractures: The Importance of the Central Fragment in Classification and Treatment

Nasoethmoid orbital fractures are perhaps the most complicated aspect of craniomaxillofacial trauma. Involvement of the medial canthal tendon markedly increases the complexity of the repair. We report a case of type II nasoethmoid orbital fracture in a 32-year-old man that was managed without formal medial canthal tendon repair; instead, we used open reduction and internal fixation of the central fragment and the nasoethmoid complex. However, during the immediate postoperative period, we noted anterior and inferior displacement of the medial canthus. We took the patient back to the operating room to address the detachment. Revision surgery was successful, and at the 6-month follow-up, his medial canthi were completely symmetrical in all dimensions. We describe our intraoperative technique and measures to prevent complications that can help the surgeon intraoperatively. We also discuss an important point that has not been adequately addressed in the literature to date—that is, the fact that the use of the frontoethmoid suture line and the anterior ethmoid artery as a guide to the skull base can be inaccurate. Problems associated with this inaccuracy can be avoided by carefully reviewing preoperative computed tomography, which can help keep the surgeon from entering the intracranial cavity while fixing the medial canthal tendon during transnasal canthal repair.

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Classification and treatment of orbital fractures

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/s0901-5027(06)80068-8 ◽

1996 ◽

Vol 25 (4) ◽

pp. 327

Keyword(s):

Orbital Fractures ◽

Classification And Treatment

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The Classification and Treatment of Headache

Medical Clinics of North America ◽

10.1016/s0025-7125(16)35236-1 ◽

1951 ◽

Vol 35 (5) ◽

pp. 1485-1493 ◽

Cited By ~ 4

Author(s):

Madelaine Ray Brown

Keyword(s):

Classification And Treatment

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Factors of Impulsivity and Cluster B Personality Dimensions

Journal of Individual Differences ◽

10.1027/1614-0001/a000237 ◽

2017 ◽

Vol 38 (4) ◽

pp. 203-210 ◽

Cited By ~ 1

Author(s):

Christopher M. Lootens ◽

Christopher D. Robertson ◽

John T. Mitchell ◽

Nathan A. Kimbrel ◽

Natalie E. Hundt ◽

...

Keyword(s):

Personality Disorders ◽

The Other ◽

Diagnostic Classification ◽

Personality Dimensions ◽

Cluster B Personality Disorders ◽

Classification And Treatment

Abstract. The goal of the present investigation was to expand the literature on impulsivity and Cluster B personality disorders (PDs) by conceptualizing impulsivity in a multidimensional manner. Two separate undergraduate samples (n = 223; n = 204) completed measures of impulsivity and Cluster B dimensions. Impulsivity was indeed predictive of Cluster B dimensions and, importantly, each PD scale exhibited a unique impulsivity profile. Findings for borderline PD scores were highly consistent across samples and strongly and positively associated with urgency and lack of perseverance, as expected. Findings for the other PD dimensions also exhibited a fair amount of consistency. Implications of these findings for diagnostic classification and treatment are discussed.

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