International Journal of Otorhinolaryngology and Head and Neck Surgery | November 2023 | Vol 9 | Issue 11 Page 852 International Journal of Otorhinolaryngology and Head and Neck Surgery Munjal M et al. Int J Otorhinolaryngol Head Neck Surg. 2023 Nov;9(11):852-855 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Original Research Article Clinical manifestations of nasoethmoid-central midface and lateral mid midface trauma: an analytical study Manish Munjal, Sonika Kanotra, Shubham Munjal*, Parth Chopra, Vanshika Saggar, Hardeep Kaur, Lovleen Sandhu, Tejbir Singh Binepal, Anjana Pillai, Hemant Chopra, Sanjeev Uppal INTRODUCTION The human face being most prominent is susceptible to trauma, be it domestic, occupational, sporting activities, road traffic and vagaries of nature. The bony skeleton or the overlying soft tissues may be involved either individually or together. 1 Facial injuries damage the individual physically as well as emotionally, moreover long hospitalization and need of multiple surgical interventions drain one financially. Sometimes there is unexpected morbidity affecting the quality of life. 2,3 Naso- Orbito-Ethmoid (NOE) trauma with sustained facial fractures necessitate unique consideration from diagnostic and therapeutic aspects. 1 The primary presentation is often grotesque orbital swelling, periorbital ecchymosis, traumatic telecanthus with accompanying CSF rhinorhea. Central midface retrusion/intrusion is noticed later after recession of acute oedema. 4-7 Lateral midface, zygomaticomaxillary complex, or zygomatico-orbital ABSTRACT Background: Patients with facial trauma were analyzed to determine the clinical presentation of fractures of the naso- ethmoid, mid and lateral face. Methods: 61 patients in the trauma unit of Dayanand Medical College were prospectively analyzed during a period of two years (August 2013 to August 2015). Results: Road traffic accidents were the major cause of fractures (72.13%) followed by assaults (14.75%) and falls (8.19%). The age group commonly affected was 21-30 years (54.09%) followed by 31-40 years (13.11%). Facial fractures were more in males, the females being 5 times less at risk. Epistaxis, swelling, tenderness, nasal obstruction, external nasal deformity and crepitus were noted in almost all patients. Ecchymosis, telecanthus and CSF rhinorrhea were noted in 90.9%, 72.7%, and 18.18% respectively. 90% presented with circumorbital ecchymosis, facial edema and anterior open bite. Other symptoms were epistaxis (81%), infraorbital nerve anesthesia and surgical emphysema (47.6%) and lengthening of face (42.8%). The commonest presentation was circumorbital ecchymosis (95.5%), subconjuctival hemorrhage (85.7%), flattening of cheek and step deformity at the infraorbital margin (81%). Facial edema was seen in 76% and trismus in 42.9%. Conclusions: Common symptoms and signs of nasoethmoid fractures included epistaxis, swelling and tenderness, nasal obstruction, external nasal deformity and crepitus in all patients, circumorbital ecchymosis in 90% and telecanthus in 73%. Keywords: Fractures, Naso ethmoid, Central midface, Lateral midface Department of ENT and Head Neck Services, Dayanand Medical College, Ludhiana, Punjab, India Received: 26 June 2023 Revised: 20 September 2023 Accepted: 21 September 2023 *Correspondence: Dr. Shubham Munjal, E-mail: manishmunjaldr@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/issn.2454-5929.ijohns20233213