Ethmoid Bone - Injuries

Injuries

Fracture of the lamina papyracea, the lateral plate of the ethmoid labyrinth bone, permits communication between the nasal cavity and the ipsilateral orbit through the inferomedial orbital wall, resulting in orbital emphysema. Increased pressure within the nasal cavity, as seen during sneezing, for example, leads to temporary exophthalmos.

The porous, fragile nature of the ethmoid bone makes it particularly susceptible to fractures. The ethmoid is usually fractured from an upward force to the nose. This could occur by hitting the dashboard in a car crash or landing on the ground after a fall. The ethmoid fracture can produce bone fragments that penetrate the cribriform plate. This trauma can lead to a leak of cerebral spinal fluid into the nasal cavity. These openings allow for opportunistic bacteria in the nasal cavity to enter the sterile environment of the central nervous system (CNS). The CNS is usually protected by the blood brain barrier, but holes in the cribriform plate allow bacteria to surpass the barrier. The blood brain barrier makes it extremely difficult to treat such infections because only certain drugs can cross in the CNS.

An ethmoid fracture can also sever the olfactory nerve. This injury results in anosmia, or the loss of smell. A reduction in the ability to taste is also a side effect because it is based so heavily on smell. This injury is not fatal.