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A knowledge of the basic surgical anatomy is needed for the clarification of terminology and for an understanding of the surgical procedures described in subsequent chapters. (Figs. 4 – 1,2,3,4,) The surgeon should be familiar with the following primary anatomy and basic landmarks: – Bony vault:             – Paired nasal bones – Paired frontal process of the maxilla (distal portion) – Cartilagenous vault: – Paired upper lateral cartilages – Dorsum septum – Tip cartilage:          – Paired lower lateral or alar cartilage – Nasal septum:        – Quadrangular cartilage – Perpendicular plate of the ethmoid – Vomer – Maxillary crest Key Anatomical Landmarks:
  1. Naison
  2. Rhinion
  3. Supratip
  4. Infratip
  5. Double break
  6. Sheen’s four landmarks on the nasal tip:
    1. The point of tip differentiation (supratip breakpoint)
    2. The right dome
    3. The left dome
    4. The columella-lobular breakpoint
  7. Angle of divergence: which refers to the separation between the two middle crura
  8. Angle of rotation:which is essentially the columella-lobular angle
  9. Columella
  10. Nasolabial angle
  11. Supra-alar
  12. Nares
  13. Alar rim
  14. Alar flare
  15. SIL
  16. Nasofrontal suture
  17. Nasal bone
    1. Bony cartilagenous junction
    2. Upper lateral cartilage
    3. Dorsum septum
    4. Superior septal angle
    5. Dome: cartilage that lies between external and internal soft triangles (Facets)
Lower lateral cartilage
  1. Lateral crus
  2. Medial crus
  3. Intermediate crura
  4. The domal junction: the transition from middle to lateral crus in refined tip
  5. Medial crus footplate
  6. Internal soft triangle
  7. External soft triangle
  8. Pyriform aperture
  9. Interdomal space
  10. Caudal septum
  11. Nasal spine
  12. Nasal vestibule: stratified squamous epithelium
  13. Mucovestibular junction
  14. Nasal septum
  15. Inferior turbinate


Fig. 4 – 1. Key anatomical landmarks

Fig. 4 – 2. Key anatomical landmarks

Fig. 4 – 3. Nasal landmarks

Fig. 4 – 4. Anatomy of the nasal septum

Refrences Surgical Anatomy
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