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Surgical anatomy of cartilaginous structures of the Asian nose: Clinical implications in rhinoplasty

Authors

  • Chang-Hoon Kim MD,

    1. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
    2. The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, South Korea
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  • Dong Hak Jung MD,

    1. Shimmian Rhinoplasty Clinic, Seoul, South Korea
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  • Mi-Na Park MD,

    1. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
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  • Joo-Heon Yoon MD

    Corresponding author
    1. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
    2. The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, South Korea
    3. Research Center for Human Natural Defense System, Yonsei University College of Medicine, Seoul, South Korea
    4. BK21 Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
    • Department of Otorhinolaryngology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
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  • This study was supported by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (R11-2007-040-02001-0 to J.-H. Yoon, 2009-0071618 and 2009-0083850 to C.-H. Kim) and a faculty research grant of Yonsei University College of Medicine (6-2008-0089 to C.-H. Kim). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

The morphologic features of upper and lower lateral cartilage and septal cartilage of the cadaveric nose were analyzed to provide practical anatomical knowledge for Asian rhinoplasty.

Study Design:

Cadaveric dissection.

Methods:

A total of 21 Korean adult cadavers were dissected. External nasal morphology was observed, measured, photographed, and analyzed. Histologic features were observed with a light microscope in coronally-transected specimens stained with hematoxylin and eosin.

Results:

The lengths of the upper and lower lateral cartilage of Korean cadaveric noses were similar to those of white noses. The widths of the upper and lower lateral cartilage were substantially smaller in Korean cadaveric noses than in those of whites. Upper lateral cartilage include substantial transverse portions near the keystone area that should be preserved in component reduction rhinoplasty. The relationships between the upper lateral cartilage and the lower lateral cartilage were divided into four types. Type I, in which the upper lateral cartilage and lower lateral cartilage are interlocked to form a Z-shape, is the most common. The posterior portion of the septal cartilage, which is connected to the perpendicular plate of the ethmoid and vomer, is thickest.

Conclusions:

Cartilaginous structures of Asian noses were substantially different from those of whites in terms of their shape, size, thickness, and relationship with other structures. The data from surgical anatomical observations of the cartilaginous framework of Korean cadaveric noses provided in this report will provide valuable information for performing rhinoplasty on Asian patients. Laryngoscope, 2010

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