Clin Exp Otorhinolaryngol.  2008 Sep;1(3):158-160. 10.3342/ceo.2008.1.3.158.

An Anatomic Study on the Overlap Patterns of Structural Components in the Keystone Area in Noses of Koreans

• Kim IS
• Chung YJ
• Lee YI

• KMID: 1486087
• DOI: http://doi.org/10.3342/ceo.2008.1.3.158

Abstract

OBJECTIVES
The keystone area has critical importance in maintaining the stability of the nasal dorsum. However, overlap patterns between structural components in the keystone area have rarely been studied, especially in the noses of Koreans.
METHODS
Dissections were performed on 18 cadaveric noses. The length and width of the structural components in the keystone area were measured. The shape of the caudal margin of the nasal bone and the overlap patterns between the upper lateral cartilage and the nasal bone were classified.
RESULTS
The shape of the caudal margin of the nasal bone were classified as follows: type A, curvilinear margin; type B, paramedian retractions or "M" shape; type C, elongated midline; and type D, retracted midline. The overlap area between the upper lateral cartilage and the nasal bone was classified as follows: type Ao, crescent shape; type Bo, short midline extension; and type Co, long midline extension. The cephalocaudal length of the overlap area between the upper lateral cartilage and the nasal bone was 4-10 mm (mean, 7 mm) in the midline, and 0-7 mm (mean, 3.1 mm) in the paramedian area. The overlap width of the upper lateral cartilage with the nasal bone was 8-14 mm (mean, 9.7 mm).
CONCLUSION
The overlap pattern of the structural components in the keystone area is variable. Therefore, a thorough understanding and a cautious evaluation of the relationships of these components before and during surgery is important in performing safe and effective nasal procedures.

Keyword

Keystone area; Nasal septum; Nasal bone; Rhinoplasty

MeSH Terms

Cadaver
Cartilage
Nasal Bone
Nasal Septum
Nose
Rhinoplasty

Figure

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  Fig. 1 Classification of the caudal margin of the nasal bone. Type A, curvilinear margin; type B, paramedian retractions or "M" shape; type C, a caudal extension of the midline over the cartilaginous dorsum; and type D, a cephalic retraction on the midline.

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  Fig. 2 Types of caudal margin of the nasal bone in cadaver dissections. (A) Type A. (B) Type B. (C) Type C. (D) Type D.

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  Fig. 3 Classification of the overlap area between the upper lateral cartilages and the nasal bone.Type Ao, crescent shape; type Bo, short midline extension; and type Co, long midline extension.

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