Surgical anatomy of the nose Dr. Chih- Yen Wei Depart. of Otolaryngology Chia-yi Christian Hospital
We want to do rhinoplasty
In doing rhinoplasty, we must have: <ul><li>Passion </li></ul><ul><li>Patient </li></ul><ul><li>Patients </li></ul><ul><li...
The first step in rhinoplasty Anatomy
Anatomy of external nose
External nose Upper 1/3 (nasal bone) middle 1/3 (upper lateral  cartilage) lower 1/3 (lower lateral cartilage)
External nose
Lateral view Infratip lobule
Keystone area
Soft tissue of external nose <ul><li>Epidermis </li></ul><ul><li>Dermis </li></ul><ul><li>Subcutaneous fat </li></ul><ul><...
Keystone area
Anatomy of nasal cavity
Nasal septum
Lateral wall of nasal cavity
Blood supply of nose
Blood supply of nasal area <ul><li>External nose: </li></ul><ul><ul><li>Ophthalmic artery    dorsal nasal artery </li></u...
 
Blood supply of nasal area <ul><li>Nasal cavity: </li></ul><ul><ul><li>Nasal septum </li></ul></ul><ul><ul><li>Lateral wal...
Blood supply of nasal septum
Nasal Tip
Factors affecting  shape & position of nasal tip <ul><li>Lateral crural  complex </li></ul><ul><li>Thickness of the overly...
Lateral crural complexes
Dome <ul><li>Anatomic dome: </li></ul><ul><ul><li>Junction of the middle and lateral crura </li></ul></ul><ul><li>Clinical...
Dome
Tip-defining point
Tripod theory
Scroll area <ul><li>Junction of lower lateral cartilage & upper lateral cartilage </li></ul><ul><li>Recurvature of the low...
Nasal valve <ul><li>Internal nasal valve </li></ul>
Nasal valve <ul><li>External nasal valve </li></ul>
Incision for rhinoplasty
Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemit...
Trans-columellar incision
Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemit...
Transfixion inicision
Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemit...
Infracartilage(marginal) incision
Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemit...
Intercartilage & cartilage-splitting incision
Quick review
Alar   Alar groove Cephalic  radix tip columella Dorsum Caudal
Nasofrontal angle  Supratip break Tip-defining point Columellar-lobular angle Posterior Anterior
Photos of Chia-yi
Thanks for your attention!!
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Surgical Anatomy Of The Nose

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Surgical Anatomy Of The Nose

  1. 1. Surgical anatomy of the nose Dr. Chih- Yen Wei Depart. of Otolaryngology Chia-yi Christian Hospital
  2. 2. We want to do rhinoplasty
  3. 3. In doing rhinoplasty, we must have: <ul><li>Passion </li></ul><ul><li>Patient </li></ul><ul><li>Patients </li></ul><ul><li>Sense of beauty </li></ul><ul><li>Knowledge </li></ul>
  4. 4. The first step in rhinoplasty Anatomy
  5. 5. Anatomy of external nose
  6. 6. External nose Upper 1/3 (nasal bone) middle 1/3 (upper lateral cartilage) lower 1/3 (lower lateral cartilage)
  7. 7. External nose
  8. 8. Lateral view Infratip lobule
  9. 9. Keystone area
  10. 10. Soft tissue of external nose <ul><li>Epidermis </li></ul><ul><li>Dermis </li></ul><ul><li>Subcutaneous fat </li></ul><ul><li>Muscle </li></ul><ul><li>Fascia </li></ul><ul><li>Areolar tissue </li></ul><ul><li>Pericondrium/ </li></ul><ul><li>Periosteum </li></ul>
  11. 11. Keystone area
  12. 12. Anatomy of nasal cavity
  13. 13. Nasal septum
  14. 14. Lateral wall of nasal cavity
  15. 15. Blood supply of nose
  16. 16. Blood supply of nasal area <ul><li>External nose: </li></ul><ul><ul><li>Ophthalmic artery  dorsal nasal artery </li></ul></ul><ul><ul><li>Facial artery ( from external carotid artery) </li></ul></ul><ul><ul><ul><li> angular artery </li></ul></ul></ul><ul><ul><ul><li> superior labial artery </li></ul></ul></ul>
  17. 18. Blood supply of nasal area <ul><li>Nasal cavity: </li></ul><ul><ul><li>Nasal septum </li></ul></ul><ul><ul><li>Lateral wall of nasal cavity </li></ul></ul>
  18. 19. Blood supply of nasal septum
  19. 20. Nasal Tip
  20. 21. Factors affecting shape & position of nasal tip <ul><li>Lateral crural complex </li></ul><ul><li>Thickness of the overlying skin </li></ul><ul><li>Ligments & fibrous attachments of nasal tip structures </li></ul>
  21. 22. Lateral crural complexes
  22. 23. Dome <ul><li>Anatomic dome: </li></ul><ul><ul><li>Junction of the middle and lateral crura </li></ul></ul><ul><li>Clinical dome: </li></ul><ul><ul><li>The most anterior projecting portion of the lower lateral cartilage </li></ul></ul><ul><li>Tip-defining point: </li></ul><ul><ul><li>The external projection of the dome </li></ul></ul>
  23. 24. Dome
  24. 25. Tip-defining point
  25. 26. Tripod theory
  26. 27. Scroll area <ul><li>Junction of lower lateral cartilage & upper lateral cartilage </li></ul><ul><li>Recurvature of the lower lateral cartilage </li></ul>
  27. 28. Nasal valve <ul><li>Internal nasal valve </li></ul>
  28. 29. Nasal valve <ul><li>External nasal valve </li></ul>
  29. 30. Incision for rhinoplasty
  30. 31. Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemitransfixion incision </li></ul><ul><li>Infracartilage(marginal) incision </li></ul><ul><li>Intercartilage incision </li></ul><ul><li>Cartilage-splitting incision </li></ul>
  31. 32. Trans-columellar incision
  32. 33. Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemitransfixion incision </li></ul><ul><li>Infracartilage(marginal) incision </li></ul><ul><li>Intercartilage incision </li></ul><ul><li>Cartilage-splitting incision </li></ul>
  33. 34. Transfixion inicision
  34. 35. Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemitransfixion incision </li></ul><ul><li>Infracartilage(marginal) incision </li></ul><ul><li>Intercartilage incision </li></ul><ul><li>Cartilage-splitting incision </li></ul>
  35. 36. Infracartilage(marginal) incision
  36. 37. Incision for rhinoplasty <ul><li>Trans-columellar incision </li></ul><ul><li>Transfixion inicision </li></ul><ul><li>Hemitransfixion incision </li></ul><ul><li>Infracartilage(marginal) incision </li></ul><ul><li>Intercartilage incision </li></ul><ul><li>Cartilage-splitting incision </li></ul>
  37. 38. Intercartilage & cartilage-splitting incision
  38. 39. Quick review
  39. 40. Alar Alar groove Cephalic radix tip columella Dorsum Caudal
  40. 41. Nasofrontal angle Supratip break Tip-defining point Columellar-lobular angle Posterior Anterior
  41. 42. Photos of Chia-yi
  42. 43. Thanks for your attention!!

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