FRCS (ORL-HNS) · SECTION 1 SBA

Naso-orbito-ethmoid fracture

After central facial trauma, the intercanthal distance is increased and the medial canthus moves with gentle traction. Which structure is most likely disrupted?

CHOOSE ONE ANSWER

Best of five

  1. A. Medial canthal tendon attachment to the central fragment
  2. B. Lateral canthal tendon
  3. C. Infraorbital nerve alone
  4. D. Zygomatic arch alone
  5. E. Nasal septal cartilage alone
ANSWER AND REASONING

A. Medial canthal tendon attachment to the central fragment

Telecanthus and an unstable canthus indicate NOE injury involving the medial canthal tendon-bearing segment.

Why every option is right or wrong

A. Medial canthal tendon attachment to the central fragment: Telecanthus and an unstable canthus indicate NOE injury involving the medial canthal tendon-bearing segment.

B. Lateral canthal tendon: This would not produce the characteristic medial telecanthus.

C. Infraorbital nerve alone: It causes cheek numbness, not canthal instability.

D. Zygomatic arch alone: It affects facial width and mouth opening rather than medial canthal attachment.

E. Nasal septal cartilage alone: It cannot explain mobile medial canthi.

What if the scenario changed?

If the tendon remained attached to a single stable central fragment, fracture classification and fixation strategy would differ.

EDUCATIONAL USE

Independent Clinora preparation material; not official JCIE content, an accredited programme or a substitute for local policy and specialist judgement.

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