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ENT · Nose and paranasal sinuses: nasoorbitoethmoid fracture
Sample itemAfter being struck on the nasal root by a bat, a man has a flattened nasal bridge, a widened distance between the inner angles of the eyes, and watering of the eye. What is the injury?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Nasoorbitoethmoid complex fracture
A nasoorbitoethmoid fracture drives the nasal bones back into the ethmoids and disrupts the medial canthal tendon attachment, giving traumatic telecanthus, a flat bridge and epiphora from lacrimal injury. It needs CT and open reduction.
Option by option
A. Nasoorbitoethmoid complex fracture (correct)
Correct. A flat bridge, telecanthus and epiphora indicate a nasoorbitoethmoid fracture.
B. Orbital floor blowout fracture
An orbital blowout gives diplopia on upgaze and enophthalmos, without telecanthus.
C. Isolated nasal bone fracture
An isolated nasal fracture gives deviation and swelling without widening of the inner eye angles.
D. Zygomaticomaxillary complex fracture
A zygomaticomaxillary fracture flattens the cheek and causes infraorbital numbness and trismus.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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