Clinical Outcomes of the H-Shaped Incision in the Surgical Management of Naso-Orbito-Ethmoidal Fractures: A Prospective Clinical Study.
- 1Department of Oral and Maxillofacial Surgery, Bharath Institute of Higher Education and Research, Chennai, IND.
- 2Department of Oral and Maxillofacial Surgery, RVS Dental College and Hospital, Coimbatore, IND.
Abstract
Background Naso-orbito-ethmoidal fractures are complex central midfacial injuries that require adequate exposure for accurate reduction and stable fixation. This study evaluated the clinical outcomes of an H-shaped incision approach for naso-orbito-ethmoidal fractures. Materials and methods This prospective single-arm study included 20 adults with clinically and radiographically confirmed naso-orbito-ethmoidal fractures requiring open reduction and internal fixation. The central fracture region was exposed through an H-shaped incision with additional infraorbital or intraoral vestibular access when required. Outcomes included operative time, surgical exposure, fracture reduction, pain, facial edema, wound healing, scar quality, neurosensory status, and complications. Patients were followed for six months. Results The mean operative time was 85.15 ± 7.05 minutes. Surgical exposure was excellent in 12 (60%) patients and good in 8 (40%) patients. Fracture reduction was excellent in 13 (65%) patients and good in 7 (35%) patients. Mean pain scores decreased from 5.25 ± 0.85 at one week to 1.45 ± 0.51 at one month (p<0.001). Mean Patient and Observer Scar Assessment Scale scores decreased from 21.95 ± 2.35 at one month to 10.15 ± 1.50 at six months (p<0.001). Three (15%) patients developed transient paresthesia. No persistent sensory deficit or clinically apparent medial canthal tendon or nasolacrimal duct injury was recorded. Conclusions The H-shaped incision approach provided adequate surgical exposure and satisfactory fracture reduction with favorable postoperative recovery in selected patients. Larger comparative studies are required to define its relative advantages over established approaches.
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BibTeX
@article{edsor2026clinical,
title = {{Clinical Outcomes of the H-Shaped Incision in the Surgical Management of Naso-Orbito-Ethmoidal Fractures: A Prospective Clinical Study.}},
author = {Effie Edsor and Prabhusankar K and Srinisha M and Priyadharsana Ps and Vignesh K and Vigneshwar S},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117015},
url = {https://europepmc.org/article/MED/42948837},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical Outcomes of the H-Shaped Incision in the Surgical Management of Naso-Orbito-Ethmoidal Fractures: A Prospective Clinical Study.
AU - Effie Edsor
AU - Prabhusankar K
AU - Srinisha M
AU - Priyadharsana Ps
AU - Vignesh K
AU - Vigneshwar S
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.117015
UR - https://europepmc.org/article/MED/42948837
AB - Background Naso-orbito-ethmoidal fractures are complex central midfacial injuries that require adequate exposure for accurate reduction and stable fixation. This study evaluated the clinical outcomes of an H-shaped incision approach for naso-orbito-ethmoidal fractures. Materials and methods This prospective single-arm study included 20 adults with clinically and radiographically confirmed naso-orbito-ethmoidal fractures requiring open reduction and internal fixation. The central fracture region was exposed through an H-shaped incision with additional infraorbital or intraoral vestibular access when required. Outcomes included operative time, surgical exposure, fracture reduction, pain, facial edema, wound healing, scar quality, neurosensory status, and complications. Patients were followed for six months. Results The mean operative time was 85.15 ± 7.05 minutes. Surgical exposure was excellent in 12 (60%) patients and good in 8 (40%) patients. Fracture reduction was excellent in 13 (65%) patients and good in 7 (35%) patients. Mean pain scores decreased from 5.25 ± 0.85 at one week to 1.45 ± 0.51 at one month (p<0.001). Mean Patient and Observer Scar Assessment Scale scores decreased from 21.95 ± 2.35 at one month to 10.15 ± 1.50 at six months (p<0.001). Three (15%) patients developed transient paresthesia. No persistent sensory deficit or clinically apparent medial canthal tendon or nasolacrimal duct injury was recorded. Conclusions The H-shaped incision approach provided adequate surgical exposure and satisfactory fracture reduction with favorable postoperative recovery in selected patients. Larger comparative studies are required to define its relative advantages over established approaches.
SN - 2168-8184
ER -