Anatomy of External Nose

The external nose, also known as the visible part of the nose, is composed of several structures that work together to form the shape of the nose and regulate the flow of air during breathing. The main structures of the external nose include:

Nasal bones: These are two small bones that form the upper part of the nose and provide support for the bridge of the nose.

Cartilage: The lower part of the nose is made up of flexible cartilage that gives the nose its shape and allows it to bend and move. The cartilage also forms the tip of the nose.

Nostrils: These are the openings at the bottom of the nose that allow air to enter and exit the nasal passages.

Nasal septum: This is the wall of cartilage and bone that separates the two nostrils from each other.

Nasal vestibule: This is the area just inside the nostrils that is lined with skin and hair. It helps to filter out dust and other particles from the air before it enters the nasal passages.

Nasal ala: These are the outer walls of the nostrils that flare outwards. They are composed of muscle, cartilage, fibrofatty tissue and help to regulate the flow of air during breathing.

Skin: The external nose is covered in skin that contains sweat glands and sebaceous glands, which help to keep the skin moist and prevent it from drying out.

Overall, the anatomy of the external nose is complex and includes a variety of structures that work together to perform the important functions of breathing and maintaining the shape of the face.

Nasal Bones

The nasal bones are two small, oblong-shaped bones that form the bridge of the nose, connecting the frontal bone of the skull to the cartilage of the lower nose. Anatomically, the nasal bones are located in the upper third of the nose, and their position and shape are essential in determining the aesthetic appearance of the face

In terms of anatomical relations, the nasal bones are located deep to the nasal skin and superficial to the nasal mucosa, which lines the inside of the nasal cavity. The nasal bones are also closely related to several other structures, including the following:

Frontal bone: The nasal bones articulate with the frontal bone, which forms the upper part of the nose and the forehead.

Ethmoid bone: The nasal bones are also in close proximity to the ethmoid bone, which forms the medial wall of the orbit (eye socket) and contributes to the structure of the nose.

Maxilla bone: The nasal bones are situated anterior to the maxilla bone, which forms the upper jaw and contains the maxillary sinuses.

Cartilage: The nasal bones articulate with the cartilage of the lower nose, including the septal cartilage and the lateral cartilages that make up the lower part of the nose.

Soft tissue: The nasal bones are covered by a layer of soft tissue, which includes the skin and subcutaneous tissue of the nose. This tissue is richly supplied with blood vessels and nerve endings, which are responsible for the sense of touch and temperature regulation.

Overall, the nasal bones have important anatomical relations that contribute to the overall structure and function of the nose. Their position and relationship to surrounding structures play a significant role in the appearance and function of the nose.

Cartilages of The Nose

The cartilages of the nose include several distinct structures, including the septal cartilage, the alar cartilages, and the lateral cartilages. The lateral cartilages of the nose, also known as the upper and lower lateral cartilages, are two curved pieces of cartilage that are located on either side of the nasal septum.

The upper lateral cartilages are thin, flat pieces of cartilage that are located at the upper part of the nasal cavity. They help to form the sidewalls of the nose and contribute to the shape and contour of the bridge of the nose. The upper lateral cartilages are also important for supporting the nasal bones and maintaining the overall structural integrity of the nose.

The lower lateral cartilages are thicker and more curved than the upper lateral cartilages. They are located at the lower part of the nasal cavity and are responsible for forming the tip of the nose. The lower lateral cartilages are highly flexible and can be shaped and contoured to achieve a desired cosmetic appearance.

Together, the upper and lower lateral cartilages of the nose work in concert with other structures, such as the septal cartilage and alar cartilages, to provide support and shape to the nose. They also play an important role in regulating the flow of air during breathing, as they help to direct air through the nasal passages and prevent the collapse of the nostrils.

In summary, the upper and lower lateral cartilages of the nose are important structures that contribute to the overall shape and function of the nose. They work together with other cartilages and bones to provide support, shape, and flexibility to the nose, while also allowing for normal respiration.

The Lower Lateral Cartilages

The lower lateral cartilages of the nose are important structures that help to form the tip and sides of the nose. They are located in the lower part of the nasal cavity and are composed of hyaline cartilage. The lower lateral cartilages are highly flexible and can be shaped and contoured to achieve a desired cosmetic appearance. The lower lateral cartilages can be further subdivided into two distinct parts: the medial crura and the lateral crura.

The medial crura of the lower lateral cartilages are two small, vertical pieces of cartilage that are located at the midline of the nose. They are attached to the septal cartilage and help to support the tip of the nose. The medial crura are typically thicker and stiffer than the lateral crura, and they are more difficult to shape and contour during rhinoplasty.

The lateral crura of the lower lateral cartilages are two larger, more flexible pieces of cartilage that are located at the sides of the nose. They are attached to the medial crura and help to form the shape and contour of the nasal tip. The lateral crura are highly flexible and can be shaped and contoured to achieve a desired cosmetic appearance. They are also responsible for regulating the flow of air during breathing, as they help to direct air through the nasal passages and prevent the collapse of the nostrils.

The structure of the lower lateral cartilages, including the medial and lateral crura, is important to understand during rhinoplasty or other nasal surgeries. Surgeons can use various techniques to reshape and contour the lower lateral cartilages to achieve a desired cosmetic appearance, while also ensuring that the nasal passages remain open and functional. Overall, the lower lateral cartilages are essential structures that contribute to the overall shape and function of the nose.

The Nasal Dorsum

The nasal dorsum is the bony and cartilaginous structure that forms the bridge of the nose. It extends from the root of the nose, where it meets the forehead, down to the nasal tip. The shape and size of the nasal dorsum can vary greatly between individuals and is an important component of the overall appearance of the nose.

The nasal dorsum is primarily composed of the nasal bones and the upper lateral cartilages. The nasal bones form the upper portion of the nasal dorsum, while the upper lateral cartilages form the sidewalls of the nose and contribute to the overall height and shape of the dorsum.

The anatomy of the nasal dorsum is complex and can be influenced by a number of factors, including genetics, age, trauma, and previous nasal surgery. A wide variety of nasal dorsum deformities can occur, ranging from a hump or bump on the bridge of the nose to a flattened or depressed dorsum.

Surgical correction of nasal dorsum deformities may involve a variety of techniques, including osteotomy (cutting and reshaping the nasal bones), cartilage grafting, and/or repositioning of the upper lateral cartilages. The specific surgical approach used will depend on the nature and severity of the deformity, as well as the individual needs and goals of the patient.

The Nasal Tip

The nasal tip is the lowermost part of the nose, which includes the skin, soft tissue, and cartilage that form the visible shape of the nose. The anatomy of the nasal tip is complex and varies greatly depending on the individual. However, there are certain key structures that are commonly found in the nasal tip.

The tip of the nose is composed of two lower lateral cartilages, as previously mentioned, which are located at the bottom of the nasal septum. The lower lateral cartilages are connected by a fibrous tissue called the membranous septum, which helps to support the tip of the nose.

Above the lower lateral cartilages are the upper lateral cartilages, which form the sidewalls of the nose. The upper lateral cartilages help to provide shape and support to the nasal bridge and tip.

The nasal tip also includes a number of ligaments and muscles, which are responsible for controlling movement and shape of the nose. For example, the depressor septi muscle pulls the tip of the nose downward, while the nasalis muscle helps to flare the nostrils.

The skin and soft tissue of the nasal tip are also important components of its anatomy. The skin of the tip is relatively thin and is closely adherent to the underlying cartilage and soft tissue. The subcutaneous tissue of the nasal tip is composed of a mixture of fat and fibrous tissue, which helps to provide support and shape to the nasal tip.

Overall, the anatomy of the nasal tip is complex and multifaceted, with a number of interconnected structures that work together to provide support and shape to the lowermost part of the nose. Understanding the anatomy of the nasal tip is important for surgeons performing rhinoplasty or other nasal surgeries, as it can greatly influence the final outcome of the procedure.

The Columella

The columella is a structure located in the centre of the nose, between the nostrils. It is a visible and important part of the nose that contributes to the overall appearance of the face. The columella is made up of several components, including the columellar skin, the columellar base, and the medial crura of the lower lateral cartilages.

The columellar skin is the skin that covers the columella. It is relatively thin and can be a different colour than the surrounding skin, which can contribute to the appearance of the nose.

The columellar base is the part of the nose where the columella attaches to the nasal septum. It is important for supporting the columella and maintaining the overall structural integrity of the nose.

The medial crura of the lower lateral cartilages are also part of the columella. They form the lowest part of the nasal septum and help to support the tip of the nose. The medial crura can be shaped and contoured during rhinoplasty to change the appearance of the nose.

Overall, the columella is an important part of the nose that can greatly influence the overall appearance of the face. It is important for surgeons to understand the anatomy of the columella when performing rhinoplasty or other nasal surgeries.

Deformities of the Nasal Tip

Deformities of the nasal tip are a common reason for seeking rhinoplasty or other nasal surgery. There are a variety of different nasal tip deformities, each with their own specific characteristics and treatment options. Some of the most common nasal tip deformities include:

Bulbous tip: A bulbous nasal tip is characterized by a rounded, overly prominent tip. This may be caused by excessively large lower lateral cartilages, excess soft tissue, or a lack of definition in the tip of the nose.

Boxy tip: A boxy nasal tip is characterized by a square, box-like appearance to the tip of the nose. This may be caused by overly large or improperly shaped lower lateral cartilages.

Pinched tip: A pinched nasal tip is characterized by a narrowing of the nasal tip, which can give the nose a pinched or overly pointed appearance. This may be caused by over-resection of the lower lateral cartilages.

Saddle nose: A saddle nose is characterized by a depression or collapse in the bridge of the nose, which can cause the nasal tip to appear overly prominent. This may be caused by trauma or other structural issues.

Asymmetry: Asymmetry in the nasal tip can be caused by a variety of factors, including variations in the size or shape of the lower lateral cartilages, deviation of the nasal septum, or asymmetry of the soft tissue.

Over-rotation: Over-rotation of the nasal tip is characterized by an overly elevated or upturned tip of the nose, which can give the nose an unnatural appearance. This may be caused by excessive cartilage removal during surgery.

Treatment for nasal tip deformities may involve a variety of surgical techniques, including reshaping of the lower lateral cartilages, grafting of cartilage or other tissues to provide additional support, and/or adjusting the position of the tip of the nose. Overall, the treatment plan for nasal tip deformities will depend on the specific nature of the deformity and the individual needs of the patient.

The Alar Sill

The alar sill is a small but important anatomical structure located at the base of the nostril in the human nose. It is a groove or depression that runs along the junction between the lateral aspect of the nostril and the outer edge of the nostril's base, where it meets the face.

The alar sill serves as an important reference point in the surgical management of the nose, particularly in rhinoplasty procedures. It is a key landmark for the placement of incisions and the reshaping of the nostrils, as well as for the preservation of the natural shape and contour of the nose.

The shape and size of the alar sill can vary between individuals and can be influenced by a variety of factors, including genetics, age, and previous nasal surgery. Changes to the alar sill can have a significant impact on the appearance and function of the nose, as well as on the overall balance and symmetry of the face.

Surgical procedures that involve the alar sill, such as alar base reduction, must be carefully planned and executed to avoid negative aesthetic and functional outcomes. Skilled and experienced aesthetic surgeons take into account the shape, size, and position of the alar sill when developing a personalized surgical plan for each patient.

The Nasal Valve

The internal nasal valve is a narrow area located at the upper part of the nasal airway, just inside the nostrils. It is formed by the nasal septum in the midline, the upper lateral cartilages on the sides, and the head of the inferior turbinate below.

The internal nasal valve is a critical point in the nasal airway that influences the airflow and resistance to airflow during breathing. It is the narrowest part of the nasal airway and is responsible for approximately 50% of the total airway resistance. Proper function of the internal nasal valve is essential for normal nasal breathing and good airflow to the lungs.

The internal nasal valve area is also one of the most commonly affected regions in the nose during nasal surgery, such as rhinoplasty or septoplasty. Changes to the structure of the internal nasal valve can have a significant impact on the nasal airflow and can result in breathing problems or nasal obstruction.

Surgical procedures aimed at improving the internal nasal valve area are called internal nasal valve surgery. These procedures may include techniques such as spreader grafts, which are cartilage grafts that widen the upper lateral cartilages to increase the internal nasal valve angle and improve nasal airflow. Other techniques may include turbinate reduction, septoplasty, and other procedures that aim to correct nasal deformities or structural issues that affect the internal nasal valve.

Sinus Anatomy

here are four pairs of paranasal sinuses, making a total of eight sinuses. These air-filled cavities are located within the bones of the skull, surrounding the nasal cavity. The four pairs of paranasal sinuses are:

Maxillary sinuses: These are the largest of the sinuses and are located in the cheekbones, under the eyes.

Ethmoid sinuses: These are a complex of multiple small air cells and are located between the eyes, near the bridge of the nose.

Frontal sinuses: These are located in the forehead, above the eyebrows.

Sphenoid sinuses: These are located deep within the skull, behind the eyes and the ethmoid sinuses.

Each sinus pair is connected to the nasal cavity via small openings called ostia, which allow mucus to drain and air to circulate. The sinuses are lined with mucous membranes that help to humidify and filter the air we breathe, as well as contribute to our immune defences.