The lost muscles of the nose

Abstract

This is a review of the muscular anatomy of the nose. Areas of inconsistency in the main anatomy texts are highlighted and concentrate particularly on the omission of three identifiable muscles from modern textbooks. Two topographical areas of the nose in need of further anatomical development are identified. In a sample of 121 subjects from the general population, 40% were found to be incapable of flaring the nostrils voluntarily or subconsciously in conjunction with energetic inspiration with the mouth closed. The authors recommend systematic clinical assessment of the nasal musculature be incorporated in the pre- and postoperative examination of the rhinoplasty patient. The division of the nose into five sections for assessment is proposed and the muscles contributing to each area are defined together with their individual surgical relevance.

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

“…It was mentioned as a "lost muscle" because it is not drawn in modern anatomy atlases. Their study indicated that this muscle begins from the canine fossa and reaches the alar base [18]. Their description in this study fits precisely with the description above.…”

Nasolabial Fold Discontinuity during Speech as a Possible Extended Cleft Phenotype

“…This was expected, as spontaneous dilation of the nares is attributed to the intrinsic muscles of the nose that do not articulate with OO, rather than to the extrinsic muscles such as levator labii superioris alaquae nasi which inserts in the OO muscle and is more closely associated with deliberate nasal flaring [Hoeyberghs et al, 1996]. …”

“…Nasal flaring, i.e., the dilation of the nares (FACS action unit 38), has been previously identified as the result of the action of the dilator naris portion of the nasalis muscle [Ekman, Friesen, & Hager, 2002; Hoeyberghs, et al, 1996]. The nasalis muscle is intrinsic to the nose and less likely to be affected by subepithelial or overt forms of clefting than the muscles used to move the upper lip during speech.…”

Rhinoplasty: Considerations for Patients with Facial Paralysis

“…8 Absence of voluntary or reflex nasal flaring in healthy subjects is associated with increased perception of subjective nasal obstruction. 6 Inspiration causes negative airway pressure at the area of the nasal valve as described by Bernoulli's principle. 9 Muscles that dilate the ala, such as dilator naris anterior, work to counteract this inspiratory pressure and keep the external nasal valve open with inspiration through the flaring mechanism.…”