Orr anatómia

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Anatomy of the Nose

What's so important about the anatomy of the nose?
The anatomy of the nose is so important because it's the main reason why your nose looks the way that it does. Because of that, it's essential that the nose's anatomy be accurately assessed, whether for a first-time rhinoplasty or a revisionary procedure, in order to develop a realistic and rational surgical plan. Accurately assessing the nose takes skill and experience.

A simplified description of the nose's anatomy
Below is a simplified diagram of the nose's anatomy, including the surface anatomy and the structural (beneath the surface) anatomy. These are reprinted with permission from the textbook Rhinoplasty Dissection Manual by Dr. Daniel Becker and Dr. Dean Toriumi.

Surface Anatomy of the Nose

You might want to print out the images, so that you can refer to them if necessary while browsing the rest of the website.

Figures 1-4 show the nose from 4 viewpoints. Important surface landmarks are labelled.

Figure 1: Frontal

1 - glabella
2 - nasion
3 - tip-defining points
4 - alar-sidewall
5 - supra-alar crease
6 - philtrum

Figure 2: 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

Figure 3: Lateral

1 - glabella
2 - nasion, nasofrontal angle
3 - rhinion (osseocartilaginous junction)
4 - supratip
5 - tip-defining points
6 - infratip lobule
7 - columella
8 - columella-labial angle or junction
9 - alar-facial groove or junction

Figure 4: Oblique

1 - glabella
2 - nasion, nasofrontal angle
3 - rhinion
4 - alar sidewall
5 - alar-facial groove or junction
6 - supratip
7 - tip-defining point
8 - philtrum

Figures 5-7 show the internal anatomy, beneath the skin.

Figure 5: Oblique

1 - nasal bone
2 - nasion (nasofrontal suture line)
3 - internasal suture line
4 - nasomaxillary suture line
5 - ascending process of maxilla
6 - rhinion (osseocartilaginous junction)
7 - upper lateral cartilage
8 - caudal edge of upper lateral cartilage
9 - anterior septal angle
10 - lower lateral cartilage - lateral crus
11 - medial crural footplate
12 - intermediate crus
13 - sesamoid cartilage
14 - pyriform aperture

Figure 6: Lateral

1 - nasal bone
2 - nasion (nasofrontal
     suture line)
3 - internasal suture line
4 - nasomaxillary suture
     line
5 - ascending process of
     maxilla
6 - rhinion
     (osseocartilaginous
     junction)
7 - upper lateral cartilage
8 - caudal edge of upper
     lateral cartilage
9 - anterior septal angle
10 - lower lateral cartilage
       lateral crus
11 - medial crural footplate
12 - intermediate crus
13 - sesamoid cartilage
14 - pyriform aperture

Figure 7: Base

1 - tip-defining point
2 - intermediate crus
3 - medial crus
4 - medial crural footplate
5 - caudal septum
6 - lateral crus
7 - naris
8 - nostril floor
9 - nostril sill
10 - alar lobule
11 - alar-facial groove or
       junction
12 - nasal spine

  

The septum is the midline structure inside your nose that divides your nose into left and right. The septum is an important structure in septorhinoplasty. Its anatomy is shown here.

Figure 8: 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 component

Figures 9-10 are not as important for the web viewer, but they highlight the important fact that the skin over the nose has muscles and blood vessels. This may seem obvious, but it is important because if the surgeon does not fully recognize the importance of this fact, they may operate in the incorrect tissue planes, which can result in violation of the muscle and blood vessels and subsequent abnormal scarring.

Figure 9: Musculature

A: Elevator muscles -
    1. Procerus
    2. Levator labii alaequae
        nasi
    3. Anomalous nasi
B: Depressor muscles -
    4. Alar nasalis
    5. Depressor septi nasi
C: Compressor muscles -
    6. Transverse nasalis
    7. Compressor narium
        minor
D: Minor dilator muscles -
    8. Dilator naris anterior
E: Other -
    9. Orbicularis oris
   10. Corrugator

Figure 10: Vasculature

1 - dorsal nasal artery
2 - lateral nasal artery
3 - angular vessels
4 - columellar artery

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