Rhinoplasty Dr Bashar Bizrah Article on: 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:

1. Nasion —
2. Rhinion Dorsum ]– Dorsum
3. Supratip —
4. Infratip
5. Double break
6. 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
7. Angle of divergence: which refers to the separation between the two middle cmra
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
18. Bony cartilagenous junction
19. Upper lateral cartilage
20. Dorsum septum
21. Superior septa! angle
22. Dome:
    cartilage that lies between external and internal soft triangles (Facets)
23. Lower lateral cartilage
24. Lateral ems
25. Medial ems
26. Intermediate cmra
27. The domal junction:
    the transition from middle to lateral ems in refined tip
28. Medial ems footplate
29. Internal soft triangle
30. External soft triangle
31. Pyriform aperture
32. Interdomal space
33. Caudal septum
34. Nasal spine
35. Nasal vestibule:
    stratified squamous epithelium
36. Mucovestibular junction
37. Nasal septum
38. 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

References

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