Analysis of the Development of the Nasal Septum and Measurement of the Harvestable Septal Cartilage in Koreans Using Three-Dimensional Facial Bone Computed Tomography Scanning

Abstract

BackgroundThe septal cartilage is the most useful donor site for autologous cartilage graft material in rhinoplasty. For successful nasal surgery, it is necessary to understand the developmental process of the nasal septum and to predict the amount of harvestable septal cartilage before surgery.MethodsOne hundred twenty-three Korean patients who underwent three-dimensional (3D) facial bone computed tomography (CT) were selected for evaluation of the midsagittal view of the nasal septum. Multiple parameters such as the area of each component of the nasal septum and the amount of harvestable septal cartilage were measured using Digimizer software.ResultsThe area of the total nasal septum showed rapid growth until the teenage years, but thereafter no significant change throughout the lifetime. However, the development of the septal cartilage showed a gradual decline due to ossification changes with aging after puberty in spite of a lack of change in the total septal area. The area of harvestable septal cartilage in young adults was 549.84±151.26 mm2 and decreased thereafter with age.ConclusionsA 3D facial bone CT scan can provide valuable information on the septal cartilage graft before rhinoplasty. Considering the developmental process of the septal cartilage identified in this study, septal surgery should not be performed until puberty due to the risk of nasal growth impairment. Furthermore, in elderly patients who show a decreased cartilage area due to ossification changes, septal cartilage harvesting should be performed carefully due to the risk of saddle nose deformity.

The Relationship Between Facial Asymmetry and Nasal Septal Deviation

“…Farkas and Cheung discovered dominant growth on the right hemiface or hypo-growth of the left. 15,19 It is hypothesized that neural crest migration is delayed on the left side. 16 Other large studies would be useful to answer this question.…”

Oriental Nose Occidentalization and Perinasal Shaping by Augmentation of the Underdeveloped Anterior Nasal Spine

“…By comparison, 3D facial images can provide valuable information. 10 Superimposable 3D volumetric assessments can evaluate and objectively present the effectiveness of the results and show patient results that are not demonstrable with standard 2D photography. 11 , 12 Therefore, superimposable 3D volumetric assessments were used to objectively evaluate the results in this study.…”

Anatomical Study of Nasal Septal Cartilage in Eastern Chinese

“…The septal base (anterior to the vomer) was the thickest area (range, 2.19 to 3.03 mm), while the thinnest was the area superior to the septal base (range, 0.74 to 0.97 mm). Jae Hee Kim et al [8] measured 152 Korean patients using 3D facial bone CT scanning and found the areas of the septal cartilage were 872.47±220.37 mm^2. Miles et al [9] found the average area of the cartilaginous septum was 817.2±167.2 mm^2, while the average height was 33.5 mm and the average width was 37.9 mm.…”