Naso-Orbito-Ethmoid Fractures: Perspective and Practices of Nigerian Surgeons

Objective: The study was to appraise the level of expertise in the management of Naso-Orbito-Ethmoid (NOE) fractures and to provide recommendation for necessary improvement in an African population. Materials and Methods: A questionnaire was designed and electronically mailed to Nigerian Oral & Maxillofacial surgeons, Plastic and Reconstructive surgeons, and Ear, Nose and Throat surgeons to assess their perspectives and practices in the diagnosis and management of NOE fractures. Further administration of questionnaire was done at the AO (Association of Osteosynthesis) principle course in Lagos, January, 2010. Information generated were coded and processed with statistical package for Social Sciences version 15.0, Chicago Illinois, USA. Results: The questionnaire was delivered to 214 surgeons, there were 112 respondents out of which 78 expressed no interest in the management of NOE fractures and 34 had interest and so completed the questionnaire. Diagnosis is largely based on plain radiographs; only 22 surgeons perform NOE trauma surgery, majority (63.9%) use existing laceration or more conservative approaches like Lynch or open sky incisions. Mini and micro-plates are employed by only 31.8% of the surgeons. Bone grafting is rarely performed but when required, the iliac crest is preferred. Repair of the nasolacrimal duct system is rarely done. Conclusion: The management of NOE fractures in Nigeria, falls short of the current best evidence in the world literature. International collaboration for improvement is recommended.