Arch Plast Surg.  2014 Mar;41(2):163-170. 10.5999/aps.2014.41.2.163.

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

• Kim JH
• Jung DJ
• Kim HS
• Kim CH
• Kim TY

• KMID: 1972041
• DOI: http://doi.org/10.5999/aps.2014.41.2.163

Abstract

BACKGROUND
The 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.
METHODS
One 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.
RESULTS
The 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.
CONCLUSIONS
A 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.

Keyword

Nasal septum; Nasal cartilage; Multidetector computed tomography

MeSH Terms

Adolescent
Aged
Aging
Cartilage*
Congenital Abnormalities
Facial Bones*
Humans
Multidetector Computed Tomography
Nasal Cartilages
Nasal Septum*
Nasal Surgical Procedures
Nose
Puberty
Rhinoplasty
Septum of Brain
Tissue Donors
Tomography, X-Ray Computed
Transplants
Young Adult