External nasal anatomy
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nasal anatomy, rhinoplasty
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External nasal anatomy
- 1. EXTERNAL NASAL ANATOMY DR SAFIKA ZAMAN DEPT OF ENT & HEAD NECK SURGERY VIMS,RKMSP
- 2. COMPONENTS • Skin • Subcutaneous tissue • Bone • Cartilage & alar fibro-fatty tissue • Mucosa
- 3. SKIN • Variable thickness. • Glands are more towards tip. • Changes are detectable
- 4. SUBCUTANEOUS TISSUE OF THE NOSE • Superficial fatty- connected to dermis. • Fibromuscular-SMAS • Deep fatty- contains neurovascular structures • periosteal layers.
- 5. SUBCUTANEOUS MUSCULO-APONEUROTIC SYSTEM • Functions of nasal muscles • Mummified nose
- 6. SUPERFICIAL ARTERIAL BLOOD SUPPLY • Facial artery • Ophthalmic artery Surgical anatomy for Asian rhinoplasty Taek Kyun Kim, Jae Yong Jeong The PLUS Plastic Surgery Clinic, Seoul, Korea
- 7. VENOUS AND LYMPHATIC DRAINAGE Danger area of face Parotid nodes Submandibular nodes
- 8. SENSORY NERVE SUPPLY • Ophthalmic and Maxillary branch of trigeminal nerve
- 10. CARTILAGE
- 11. TERMINOLOGY
- 14. INSPECTION OF THE EXTERNAL NOSE • Skin quality • Length of the nose: nasion to the tip.
- 16. TIP PROJECTION • Goode’s ratio, where a line drawn from the alar- facial groove to the nasal tip measures 0.55– 0.60 of the distance from the nasion to the nasal tip. Source- scott browns text book 8th edition
- 17. LIP-CHIN RELATIONSHIP • calculated from nasomental line- retrognathic or prognathic. Source- Scott Browns text book 8th edition
- 18. COLUMELLAR SHOW Source- Scott Browns text book 8th edition
- 19. TIP CONFIGURATION • Four tip-defining points identified by light reflection- domes, supra tip and infra-tip. Appearances: normal, boxy, bifid, bulbous and
- 20. TIP ROTATION • position of the tip along an arc with its radius centred on the nasolabial angle.
- 21. BASAL VIEW • Alar base configuration: isosceles triangle with pear-shaped nostrils lying at an angle of 45 °to the vertical.
- 22. INTERNAL NOSE INSPECTION • Septum • Turbinates • Valve area
- 23. PALPATION • Skin elasticity and skin texture • Bony irregularities • Tip recoil • Alar cartridges and septum strength.
- 24. ANGLE OF NOSE IN RELATION TO RHINOPLASTY
- 25. TRIANGLE OF POWELL AND HUMPHREY Source- scott browns text book 8th edition
- 26. RHINOPLASTY PHOTOGRAPHY • Light Sources: shadow-less image • The optimal lighting set-up includes two flash units on both side of camera with an angle of 45 degree. • Important considerations include focus, depth of field, distortion, consistency, and well as patient preparation and positioning.
- 27. CONT.. Positioning: Frankfort plane is parallel to the floor. standard photographic views- 1.frontal 2. left and right lateral. 3. left and right oblique 4. basal.
- 28. SUMMARY FOR PLANNING Source- Scott Browns text book 8th edition
- 29. Thank you