Studies on the Support of the Nasal Tip

Janeke, Johan B.; Wright, William K.

doi:10.1001/archotol.1971.00770060704004

Cited by 127 publications

(64 citation statements)

References 2 publications

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“…11 Based on the previous investigation, Janeke and Wright showed that a thin and loose connection exists between the medial crus of the lower lateral cartilage and the caudal septum. 1 McCollough have reported that the membranous attachment exists in this structure, 3 whereas Daniel have reported that any direct attachment does not exist in this structure in his study using cadavers. 5 Furthermore, Gunter have reported the existence of the tissue fibers only, and Kridel have reported the existence of the ligamentous attachment.…”

Section: Han Et Almentioning

confidence: 86%

“…8,22,23 For the supporting structure between the upper lateral cartilage and the lateral crus, Janeke and Wright have examined the macroscopic study using the cadaver, and reported that the cephalic rim of the lower lateral cartilage is firmly anchored to the caudal margin of the upper lateral cartilage with the fibrous tissue. 1 Kridel also called this supporting structure the fibrous attachment. 8 Gunter called this connec- Nasal Tip Supporting Structures tion connective tissue.…”

Section: Discussionmentioning

confidence: 99%

“…5 Janeke and Wright have investigated this supporting structure using cadavers and named it the sesamoid complex. 1 Gunter has shown that this supporting structure is connected to the accessory cartilage and the perichondrium and named it the lateral crural complex. 7 Adamson has emphasized that these are important supporting structures being composed of ligamentous fibrous tissue and named it the nasal hinge.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Although the study for these nasal tip supporting structures have been performed by many researchers, the terms and definitions for these structures, except for dermocartilaginous ligament, have not been defined clearly. The structure between the upper and the lower lateral cartilages has been described as fibrous tissue or connection, 1,16,17 intercartilaginous ligament, 2 ligament-like arrangement, 4 or connective tissue. 7 The structure between the lateral crus and the pyriform aperture has been described as definite fibrous attachment 5 or ligamentous fibrous tissue.…”

mentioning

confidence: 99%

“…7 The structure between the lateral crus and the pyriform aperture has been described as definite fibrous attachment 5 or ligamentous fibrous tissue. 10,18 The structure between the paired domes of the lower lateral cartilages has been described as interdomal ligament, 1,19 suspensory ligament, 7,16 or dense irregularly interwoven connective tissue. 11 The structure between the medial crus and the caudal septum has been described as loose connection, 1 membranous attachment, 3 no direct attachment, 5 or ligamentous attachment.…”

mentioning

confidence: 99%

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An Anatomic Study of Nasal Tip Supporting Structures

Han

Lee

Kim

et al. 2004

Annals of Plastic Surgery

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Successful rhinoplasty depends on nasal tip support and its influence on nasal tip projection. It is generally agreed that the components of nasal tip support include the attachment between the upper and lower lateral cartilages, the attachment between the lateral crus of the lower lateral cartilage and the pyriform aperture, the attachment between the paired domes of the lower lateral cartilages, and the medial crural attachment to the caudal septum. However, these structures are still not clearly determined, and there was no anatomic study of nasal tip supporting structures in Asia. The purpose of this study was to determine the nasal tip supporting structures and find out the differences in these structures between white and Asian people. Ten noses of fresh cadavers were investigated. Dissection was performed and the previously mentioned nasal tip supporting structures were observed and excised. Histologic examination was done with hematoxylin and eosin stain and Van Gieson elastin stain. Macroscopic study showed that there were dense fibrous tissue between the upper and lower lateral cartilages, dense fibrous tissue and sesamoid cartilages between the lateral crus and the pyriform aperture, loose connective tissue between the paired domes of lower lateral cartilages, and no identified specific tissue between the medial crus and the caudal septum. Microscopic investigation allowed a more detailed analysis of these structures. Between the upper and lower lateral cartilages, dense collagen fibers were running in one direction and anchoring firmly to each cartilage, which meets the histologic criteria of a ligament. Between the lateral crus and the pyriform aperture, there were intermingled collagen fibers and muscular fibers, which meets the histologic criteria of fibromuscular tissue. Between the paired domes of lower lateral cartilages, there were few fibers with abundant amorphous ground substances, which meets the histologic criteria of loose connective tissue. Based on our results, we recommend that the previously mentioned nasal tip supporting structures should be named intercartilaginous ligament, sesamoid fibromuscular tissue, and interdomal loose connective tissue, respectively. In addition, we consider that the loose connection between the domes of middle crura and the absence of an attachment of the medial crura to the caudal septum can be one of the reasons why the nasal tip of Asian people is broad and unprojected and the base is wide.

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Section: Han Et Almentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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An Anatomic Study of Nasal Tip Supporting Structures

Han

Lee

Kim

et al. 2004

Annals of Plastic Surgery

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The Tripod Theory of Nasal Tip Support Revisited

Westreich

Lawson

2008

Archives of Facial Plastic Surgery

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To extrapolate on the tripod concept to create a more universal and multiethnic model that includes common anatomical configurations and strategies to avoid certain unwanted surgical outcomes. Methods: Analysis of current surgical methods, scientific studies, and predominant theories to produce a new model of nasal tip support based on the biomechanical properties of the nasal cartilages. Results: The nasal tip acts as a cantilevered spring that associates with other rigid and semirigid regions of the nose. Application of these concepts resulted in preservation of projection and tip rotation in appropriately selected patients. Conclusion: The cantilevered spring tripod provides a more universal model for explaining nasal tip dynamics in a contemporary multiethnic population of patients seeking functional or cosmetic rhinoplasty correction.

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Citation Manager

2008

Archives of Facial Plastic Surgery

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Studies on the Support of the Nasal Tip

Cited by 127 publications

References 2 publications

An Anatomic Study of Nasal Tip Supporting Structures

An Anatomic Study of Nasal Tip Supporting Structures

The Tripod Theory of Nasal Tip Support Revisited

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