Acquired defects of the nose and naso-orbitoethmoid (NOE) region.

Nasal injuries coupled with midface fractures of the orbit and ethmoids constitute a nasoorbitoethmoid (NOE) fracture pattern, which is typically the most challenging facial fracture to repair. Hard and soft tissue defects of this region may require advanced reconstruction techniques, including local rotational flaps, free tissue transfer, and even prosthetics. The restoration of form and function dictates treatment, and the success of primary repair is paramount, because secondary correction is challenging in this area of the midface. Because of the complex nature of this region, this discussion is divided into hard tissue defects, with a focus on trauma, and soft tissue defects, with a focus on oncology.