Aim of the study The purpose of this study is to demonstrate our experience in establishing the indication of surgery for fractures of the naso-orbito-ethmoidal (NOE) complex. Material and methods We reviewed 24 cases of NOE fractures, of which 18 patients had indication for surgery due to the presence of important deformity of the central face, the presence of telecanthus, diplopia or important nasal obstruction. The remaining 6 did not undergo surgery due to concurrent neurosurgical conditions, the presence of a cerebrospinal fluid fistula or associated general conditions. Results The results were favourable regarding both morphologic reconstruction and function restoration. The complex shape and projection of the nasal and paranasal areas were restored. Diplopia resolved postoperatively, and a good patency of the nasal cavity was achieved. There were no infectious complications postoperatively and no cerebrospinal fluid fistulas developed following surgery. Conclusions Primary surgery for NOE complex fractures should be performed when accurately indicated for avoiding the occurrence of sequelae.
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