Rhinoplasty  (Nose Anatomy)
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Rhinoplasty (Nose Anatomy)



ENT assignment.

ENT assignment.



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Rhinoplasty  (Nose Anatomy) Rhinoplasty (Nose Anatomy) Presentation Transcript

  • Rhinoplasty(Anatomy of Nose) Prepared by : Ahmad Abid Bin Abas 07-5-2
  • External Nose
  •  Base 1 – infratip lobule 2 - columella 3 – alar sidewall 4 – facet, or soft-tissue triangle 5 - nostril sill 6 - columella-labial angle or junction 7 - alar-facial groove or junction 8 - tip defining points
  • Vascular Anatomy of Nose
  • Figure: Septum 1 – quadrangular caratilage 2 – nasal spine 3 – posterior septal angle 4 – middle septal angle 5 – anterior septal angle 6 – vomer 7 – perpendicular plate of ethmoid bone 8 – maxillary crest, maxillary component 9 – maxillary crest – palatine componentNasal Septum
  • Vascular Supply of Nasal Septum
  • 1) Procerus muscle2) Frontal sinus3) Frontal bone4) Frontal spine5) Nasal bone6) Transverse part of nasalis muscle7) Alar part of nasalis muscle8) Major alar cartilage and attach of nasal muscles9) Nasal fibro-adipose tissue10) Maxillary bone11) Levator nasal septi muscle12) Depressor nasal septi muscle13) Highest part of alveolar processMuscles of Nose
  •  1- Tip subunit 2- Columellar subunit 3- Right alar base subunit 4- Right alar side wall subunit 5- Right alar base subunit 6- Left alar base subunit 7- Dorsal subunit 8- Right dorsal side wall subunit 9- Left dorsal side wall subunitNasal Subunit
  •  The internal valve is defined by the angle that the septum makes with the upper lateral cartilage. Usually 10-15 degrees in Caucasian (wider in African or Asian nose) The narrowest portion of the nasal cavity Superior- Caudal end of ULC and Septum Posterior – Head of inferior turbinate Inferior – Nasal Floor Lateral – Bony pyriform aperture and adjacent fibrofatty tissue.Internal Nasal Valve Anatomy
  •  Nasal Vestibule (compartment caudal to INV) Fibrofatty tissue of alar lobule and LLC. Fascia continuous w/perichondrium and periosteum Caudal septum Pyriform aperture.External Nasal Valve
  •  This is a condition where the sidewalls of the nostrils collapse as breathe in. Causes : 1) Post Operative Stenosis (trauma,surgery,iatrogenic,reduction rhinoplasty) 2) Deviated Septum : (most common cause of INV collapse) 3) Septoplasty and Turbinate Reduction : (Most common procedures addressing nasal valve obstruction) 4) Turbinate Hypertrophy : (INV stenosis,mucosal or bony)Nasal Valve Collapse
  •  Spreader Grafts (Widely used,correct lack of dorsal support to lateral walls) - Spreader Grafts Placement Endonasal Placement (Septoplasty approach) Endoscopic Placement (Cadaver study : Increase area on acoustic rhinometry) Septal Crossbar (Increase nasal valve patency) Spring Graft ULC Suspension( Elevation of dorsal ULC) Flaring Suture (Improve INV angle,open approach) Mini Spreader Grafts Autospreader flapTechniques to treat Nasal Collapse
  •  Nasal obstruction is bad. Nasal surgery is good.Conclusion
  •  References: T . Fattahi - An overview of facial aesthetic units. Journal of Oral and Maxillofacial Surgery http://emedicine.medscape.com/article/835134-overview#aw2aab6b7 http://www.revisionrhinoplasty.com/anatomy.html http://www.todaysface.com/Articles/Ch044thenasalseptum03.html Rhinoplasty and The Nasal Valve, University of Texas Dept of Otolaryngology Jan 16,2008. http://www.docstoc.com/docs/82309760/Rhinoplasty-and-the-Nasal-ValveReferences