Do the upper lateral nasal cartilages exist? The concept of septolateral cartilages

Abstract Background Rhinoplasty in the elderly requires different surgical approaches due to the morphological and structural changes affecting the nose over time. Objectives In this study, the authors aimed to evaluate the age-related cellular and architectural changes of nasal cartilages and soft tissue attachments. Methods This prospective study included 80 patients who underwent rhinoplasty. Patients were divided into 2 groups according to age. Group I included 40 patients ranging in age from 19 to 39 years. Group II included 40 patients aged at least 40 years. Samples from nasal cartilages (upper lateral, lower lateral, and septum) and nasal attachments (interdomal, inter-cartilaginous, and septo-crural) were taken. All specimens were evaluated histologically to detect age-related changes. A modified version of the Mankin grading scale was used to score each nasal cartilage sample. All attachment samples were examined by image analysis for quantitative assessment. The results were correlated to preoperative anthropometric measurements of nasolabial angle and nasal projection. Results Histologically, in group II, the cartilage matrix showed fibrinoid degeneration with a significant decrease in the number of chondrocytes and increased perichondrial fibrosis compared with group I. Attachments in group II showed a lower number of blood vessels and decreased percentage of collagen bundles. Modified Mankin scores were significantly higher in group II, indicating weak cartilages compared with group I. There was negative correlation and significance between projection, nasolabial angle, cartilages, and attachments in study groups. The linear regression model revealed that the lower lateral cartilage is the cartilage that is most affected by the aging process. Conclusions These findings not only enhance our current understanding of the natural changes that occur in the nose during aging but may also affect surgical decision-making when grafting or suturing are considered during rhinoplasty. Level of Evidence: 2

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The nasal cavity and paranasal sinuses

Anatomy for Dental Students ◽

10.1093/oso/9780199234462.003.0036 ◽

2013 ◽

Author(s):

Martin E. Atkinson

Keyword(s):

Nasal Cavity ◽

Nasal Septum ◽

Goblet Cells ◽

Septal Cartilage ◽

Olfactory Mucosa ◽

Nasal Cartilages ◽

Orbital Roof ◽

External Nose ◽

The Right ◽

Lateral Walls

The nasal cavity is the entrance to the respiratory tract. Its functions are to clean, warm, and humidify air as it is inhaled. Respiratory mucosa covered by pseudostratified ciliated epithelium and goblet cells, as described in Chapter 5 and illustrated in Figure 5.2B, lines the majority of the nasal cavity. The cilia and mucus trap particles, thus cleaning the air; the mucus also humidifies the air and warming is achieved through heat exchange from blood in the very vascular mucosa. The efficiency of all these processes is increased by expanding the surface of the nasal cavity by folds of bone. The nasal cavity also houses the olfactory mucosa for the special sense of olfaction although the olfactory mucosa occupies a very small proportion of the surface of the nasal cavity. The nasal cavity extends from the nostrils on the lower aspect of the external nose to the two posterior nasal apertures between the medial pterygoid plates where it is in continuation with the nasopharynx. Bear in mind that in dried or model skulls, the nasal cavity is smaller from front to back and the anterior nasal apertures seem extremely large because the cartilaginous skeleton of the external nose is lost during preparation of dried skulls. As you can see in Figure 27.1 , the nasal cavity extends vertically from the cribriform plate of the ethmoid at about the level of the orbital roof above to the palate, separating it from the oral cavity below. Figure 27.1 also shows that the nasal cavity is relatively narrow from side to side, especially in its upper part between the two orbits and widens where it sits between the right and left sides of the upper jaw below the orbits. The nasal cavity is completely divided into right and left compartments by the nasal septum . From the anterior view seen in Figure 27.1 , you can see that the surface area of lateral walls of the nasal cavity are extended by the three folds of bone, the nasal conchae. The skeleton of the external nose shown in Figure 27.2 comprises the nasal bones, the upper and lower nasal cartilages, the septal cartilage, and the cartilaginous part of the nasal septum.

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The nose and paranasal sinuses

10.1093/med/9780198767831.003.0013 ◽

2021 ◽

pp. 455-496

Author(s):

Daniel R. van Gijn ◽

Jonathan Dunne

Keyword(s):

Paranasal Sinuses ◽

Nasal Septum ◽

Side Wall ◽

Nasal Valve ◽

Nasal Tip ◽

Nasal Cartilages ◽

Nasal Bones ◽

External Nose ◽

Nasal Side ◽

Nose And Paranasal Sinuses

The external nose is pyramidal and consists of a bony cartilaginous framework. The root/radix is continuous with the forehead an inferiorly terminates at the nasal tip. The dorsum of the nose is formed by two lateral surfaces that converge in the midline. The cartilaginous structure of the nose is formed by paired upper (lateral) cartilages that contribute to the internal nasal valve with the nasal bones, and lower lateral cartilages, combined with additional minor nasal cartilages that surround the ala. The nasal septum relies upon anastomoses from five vessels: two from the ophthalmic, two from the maxillary and one from the facial. Collectively, they form Kieselbach’s plexus. The paranasal sinuses are the frontal, sphenoidal, ethmoidal and maxillary – located within the bones of the same name. They are paired structures lined with mucosa that is continuous with the lateral nasal side wall into which they drain, facilitating clearance of mucus by way of the mucociliary escalator.

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Commentary on: Anatomic and Anthropometric Analysis of 72 Lower Lateral Nasal Cartilages From Fresh Persian (Iranian) Cadavers

Aesthetic Surgery Journal ◽

10.1177/1090820x12442534 ◽

2012 ◽

Vol 32 (4) ◽

pp. 454-455 ◽

Cited By ~ 1

Author(s):

R. P. Gruber

Keyword(s):

Nasal Cartilages

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Biomechanical characterisation of the human nasal cartilages; implications for tissue engineering

Journal of Materials Science Materials in Medicine ◽

10.1007/s10856-015-5619-8 ◽

2015 ◽

Vol 27 (1) ◽

Cited By ~ 21

Author(s):

M. F. Griffin ◽

Y. Premakumar ◽

A. M. Seifalian ◽

M. Szarko ◽

P. E. M. Butler

Keyword(s):

Tissue Engineering ◽

Nasal Cartilages

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Relation of the external nose to the bony nose and nasal cartilages in whites and negroes

American Journal of Physical Anthropology ◽

10.1002/ajpa.1330010304 ◽

1918 ◽

Vol 1 (3) ◽

pp. 329-338 ◽

Cited By ~ 42

Author(s):

Adolf H. Schultz

Keyword(s):

Nasal Cartilages ◽

External Nose

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A neomorphic ossification of the nasal cartilages and the structure of paranasal sinus system of the glyptodontNeosclerocalyptus Paula Couto 1957 (Mammalia, Xenarthra)

Palaeontologia Electronica ◽

10.26879/333 ◽

2012 ◽

Cited By ~ 1

Author(s):

J Fernicola ◽

N Toledo ◽

MS Bargo ◽

SF Vizcaíno

Keyword(s):

Paranasal Sinus ◽

Nasal Cartilages

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Histological comparison of the alar nasal cartilages in unilateral cleft lip

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812002000400004 ◽

2002 ◽

Vol 57 (4) ◽

pp. 143-146 ◽

Cited By ~ 2

Author(s):

Miguel Modolin ◽

Glaucia Zeferino Baracat ◽

Luiz Kamakura ◽

Wilson Cintra Jr. ◽

Luiz Gustavo Balaguer Cruz ◽

...

Keyword(s):

Cleft Lip ◽

Cartilage Matrix ◽

Histological Evidence ◽

Nasal Cartilages ◽

Healthy Side ◽

Lateral Portion ◽

Hematoxylin And Eosin ◽

Nasal Changes

Patients with unilateral cleft lip display characteristic nasal changes that are independent of the degree of deformity. Defenders of the intrinsic theory consider these deformities to be due to embryogenic alterations of the alar nasal cartilages. Those that propose the extrinsic theory defend the thesis that the deformity is due to disorganization of the perioral muscles deformed by the cleft. The purpose of this study is to contribute histological evidence to help clarify the issue. PATIENTS AND METHODS: Specimens of the lateral portion of both the healthy and the cleft side of the alar cartilages were obtained from 18 patients. These uniformly cut specimens were stained by hematoxylin and eosin. Samples from 2 patients were excluded due to imperfections. The same pathologist examined all the slides. He was unaware of the origins of the specimens; he counted the number of chondrocytes and quantified the cartilage matrixes. RESULTS: All data was analyzed statistically, and no significant statistical differences were apparent, either in the number of chondrocytes or the cartilage matrix between the healthy side and the cleft side. DISCUSSION: These results apparently support the group that defend the extrinsic theory; nevertheless, the doubt about the composition of the cartilage matrix remains, not only concerning the glycosaminoglycans that compose them, but also regarding elastin and collagen and its linkages that can cause different degrees of collagen consistency.

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