A functional anatomic study of the relationship of the nasal cartilages and muscles to the nasal valve area

Abstract

The functioning of the nasal valve area is largely determined by the stability and the mobility of the lateral nasal wall. To gain insight into the kinematics of the lateral nasal wall, we studied the functional anatomy of the nasal muscles and the intercartilaginous and osseous-cartilaginous junctions. We performed gross and microscopic nasal dissection and serial sectioning in 15 human cadaveric noses. In addition, two noses were used for three-dimensional reconstruction of the nasal cartilages. We conclude that the lateral nasal wall can be seen as made up of three parts. At the level of the osseous-cartilaginous chain of bone, lateral nasal cartilage, and lateral crus, the lateral nasal wall is relatively stable, limited mobility being allowed by translation and rotation in the intercartilaginous joint and a coupled distortion of the cartilages. At the level of the hinge area the lateral nasal wall is supported by one or more accessory cartilages, embedded in soft tissue, and therefore much more compliant. The alar part of the nasalis muscle, which originates from the maxilla and inserts on these cartilages, may dilate the valve area by drawing this hinge area laterally. The third and most compliant part of the lateral nasal wall is the part that is not supported by cartilage, the ala. The dilatator naris muscle largely occupies the ala and is attached to the lateral crus; it opens the vestibule and nostril. The third nasal muscle that influences the lateral nasal wall is the transverse part of the nasalis muscle. It overlies the nose but is not attached to it. This muscle stabilizes the lateral nasal wall, in particular, the lateral nasal cartilage, the intercartilaginous junction, and the hinge area, by moving the nasal skin.

Nasal Dilator Strips

“…reactivity of th e head of the inferior turbina te that produces the majority of the valvul a r action at this site. 2 By contrast , we b li v that alar flarin g on inspiration is both passive (Bernoulli's principl ) and active (the dilator nar s muscl e). Flaring appears to act to stent the upper lateral cartilag through the intercartilaginous ligaments and will help to stabilize the later l wall of the nose at the Laryngoscope 110: January 2000 178 level of the valve.…”

“…However, it is not influenced by the application of an external splint. 2 Finally, in what we assume was an effort to make the differences obtained look more meaningful than they were, the authors have shown means and standard errors of the means for their data when they should have listed the means and stand ard deviations. In addition they have failed to show that their sample is normally distributed and have thus failed to justify using a parametric analysis.…”

Válvula nasal: anatomia e fisiologia

“…The procerus and upper lip elevator muscles and nasal wing have a greater action on facial expression 26 .…”

“…Its lateral wall is concave and corresponds to the internal face of the ILC lateral crus, and it is covered by skin with hair and vibrissae. The literature is controversial in terms of nasal muscles function and anatomy 26 . The nasal muscles -nasal dilator muscle, nasal apex muscle, nasal muscle (wing part) and septum depressor muscleaccording to the anatomical description (Chart 1) 26 , have a dilatory function by voluntary contraction of the nostril and the nasal vestibule to increase air flow and in facial expression.…”

“…The literature is controversial in terms of nasal muscles function and anatomy 26 . The nasal muscles -nasal dilator muscle, nasal apex muscle, nasal muscle (wing part) and septum depressor muscleaccording to the anatomical description (Chart 1) 26 , have a dilatory function by voluntary contraction of the nostril and the nasal vestibule to increase air flow and in facial expression. Some authors 27,28 state that there are mild involuntary contractions of these muscles, perceivable by electromyography during breathing, thus facilitating airflow, and also a passive movement caused by airflow itself.…”