Rhinoplasty Surgical Anatomy

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:

Naison Rhinion Supratip Infratip Double break Sheen’s four landmarks on the nasal tip: The point of tip differentiation (supratip breakpoint) The right dome The left dome The columella-lobular breakpoint Angle of divergence: which refers to the separation between the two middle crura Angle of rotation:which is essentially the columella-lobular angle Columella Nasolabial angle Supra-alar Nares Alar rim Alar flare SIL Nasofrontal suture Nasal bone

Bony cartilagenous junction Upper lateral cartilage Dorsum septum Superior septal angle Dome: cartilage that lies between external and internal soft triangles (Facets) Lower lateral cartilage Lateral crus Medial crus Intermediate crura The domal junction: the transition from middle to lateral crus in refined tip Medial crus footplate Internal soft triangle External soft triangle Pyriform aperture Interdomal space Caudal septum Nasal spine Nasal vestibule: stratified squamous epithelium Mucovestibular junction Nasal septum 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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