Effect of the Depressor Septi Nasi Muscle Modification on Nasal Tip Rotation and Projection

Toutounchi, Javad S.; Biroon, Sogol H.; Banaem, Samira Moghaddam; Toutounchi, Neghisa; Nezami, Nariman; Salari, Behzad

doi:10.1007/s00266-015-0469-9

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Furthermore, it is shown to be the inferomedial border of the "deep pyriform space." In this study, the depressor muscle was shown to lie immediately under the nostril base [13]. However, our dissections showed a deeper muscle that lies more profound in this space.…”

Section: Discussionmentioning

confidence: 44%

The Myrtiformis Muscle: Identification of a Forgotten Entity That Is Distinct From the Depressor Septi Nasi Muscle

Yeğin¹,

Bilge²,

Çelik³

2023

Cureus

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Introduction: Nasal musculature anatomy is a topic that plastic surgeons pay attention to. However, the presence and role of the myrtiformis muscle (MM) remain controversial. To elucidate these aspects, an anatomy-based study was conducted.Materials and methods: Seven midsagittally split and two total cadaver head's nasal bases, embalmed with modified Larssen solution (MLS), were dissected for MM anatomy. The features of this muscle were photographed, and a video of its function was recorded.Results: It was found that MM originates from the maxillary alveolar process and continues as two heads, one reaching the alar base with spicular fibrotendinous endings and the other extending to depressor septi nasi fibers. Owing to its bi-vectoral muscle fibers, MM is found to constrict the nares by simultaneously forcing the alar base and lowering the columella. It was also found that left-sided muscles were larger than right-sided muscles.Conclusions: The MM is found to be a constrictor muscle of the nares in this study, contrary to recent observations.

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Section: Discussionmentioning

confidence: 44%

The Myrtiformis Muscle: Identification of a Forgotten Entity That Is Distinct From the Depressor Septi Nasi Muscle

Yeğin¹,

Bilge²,

Çelik³

2023

Cureus

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“…These alterations are used during both cosmetic and functional rhinoplasty. Although several studies have focused on evaluating how tip modifications affect other regions of the nose along with its overall appearance, the data assessing how these maneuvers affect adjacent facial structures are more limited …”

Section: Introductionmentioning

confidence: 99%

“…Although several studies have focused on evaluating how tip modifications affect other regions of the nose along with its overall appearance, the data assessing how these maneuvers affect adjacent facial structures are more limited. 1,2 The 2 most common techniques to increase tip projection are placement of a columellar strut and performing a tongue-in-groove maneuver. The columellar strut graft is a tai-lored piece of cartilage that is placed between the medial crura of the lower lateral cartilages and spans from the premaxilla to the nasal tip.…”

mentioning

confidence: 99%

Association of Increasing Nasal Tip Projection With Lip Position in Primary Rhinoplasty

Cerrati

Dayan

2017

JAMA Facial Plast Surg

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ip modification is an integral part of rhinoplasty. It is arguably the most difficult and complex part of the procedure owing to the many variables that can be altered. Besides changing the shape of the nasal tip, several of the maneuvers in rhinoplasty involve changing the tip location, whether that is projection and/or rotation. These alterations are used during both cosmetic and functional rhinoplasty. Although several studies have focused on evaluating how tip modifications affect other regions of the nose along with its overall appearance, the data assessing how these maneuvers affect adjacent facial structures are more limited. 1,2 The 2 most common techniques to increase tip projection are placement of a columellar strut and performing a tongue-in-groove maneuver. The columellar strut graft is a tailored piece of cartilage that is placed between the medial crura of the lower lateral cartilages and spans from the premaxilla to the nasal tip. 3 According to the tripod theory of nasal tip support by Anderson, 4 it can be visualized how this graft pushes the tip outward and how the rest of the nose responds. This maneuver is usually performed when the patient's septal length is within the normal limits. If a patient has a longer septum, however, the medial crura can be set back and sutured onto the septum. In doing so, the placement of this suture will dictate the location of the tip. The technique of suturing the medial crura to the caudal septum is called a tongue-in-groove maneuver. 5 If the patient has a shorter septum, a caudal septal extension graft can be placed, followed by a similar tonguein-groove maneuver. IMPORTANCE The effects of rhinoplasty maneuvers on adjacent facial features are an important component in preoperative planning and patient counseling. Tip projection modifications are commonly performed in both cosmetic and reconstructive rhinoplasty. OBJECTIVE To evaluate the subsequent change in lip projection that results from increasing nasal tip projection. DESIGN, SETTING, AND PARTICIPANTS In this case series, 20 patients underwent primary rhinoplasty with the objective of increasing tip projection during the period from October 1, 2014, to September 25, 2015. Preoperative and postoperative photographs were evaluated. MAIN OUTCOMES AND MEASURES The increased tip projection was verified using the Goode ratio. Upper lip projection was calculated by the Z angle, which is based on the intersection between the Frankfort horizontal plane and the profile line. Vermilion height was also assessed. RESULTS Of the 20 patients in the study (19 females and 1 male; mean [SD] age, 26.8 [10.2] years; range, 16-52 years) 18 (90%) demonstrated an increase in upper lip projection when the tip projection was increased by either a columellar strut or tongue-in-groove maneuver. The Z angle demonstrated a statistically significant decrease of 2.7°(95% CI, 1.5°-3.9°; P < .001). Although the vermilion height did not change a significant amount, there was a trend toward an increase in mean height of 0.051 (95% CI,-0...

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Prevalence of transverse upper labial crease

Beer

Manestar

2017

Eur J Plast Surg

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Effect of the Depressor Septi Nasi Muscle Modification on Nasal Tip Rotation and Projection

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 6 publications

References 24 publications

The Myrtiformis Muscle: Identification of a Forgotten Entity That Is Distinct From the Depressor Septi Nasi Muscle

The Myrtiformis Muscle: Identification of a Forgotten Entity That Is Distinct From the Depressor Septi Nasi Muscle

Association of Increasing Nasal Tip Projection With Lip Position in Primary Rhinoplasty

Prevalence of transverse upper labial crease

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