Nasal dorsum 2023.pptx

small presentation on nasal dorsum

1. Dr saud aldhabaan Nasal dorsum

2. Management of the Upper Two Thirds of the Nose Anatomy The upper two thirds of the nose contains the dorsum and sidewall aesthetic subunits

3. Anatomy the upper two thirds of the nose is that portion from the nasion to the level of the alar groove

4. Skin and Subcutaneous Tissue The skin overlying the upper nasal two thirds has variable thickness. thick at the nasion (2 to 5 mm), it becomes thin and mobile over the dorsum (3.2 mm), thinnest at the rhinion (2 to 2.2 mm),

5. Nasal Bones and Upper Lateral Cartilages paired The nasal bones and the paired ascending processes of the maxilla comprise the bony vault the cartilaginous vault is composed of the upper lateral cartilages and the cartilaginous dorsal septum

6. nasal keystone area The nasal keystone area is the convergence of the caudal margin of the nasal bones, the perpendicular plate of the ethmoid bone, the cephalic margin of the upper lateral cartilages, and the cartilaginous septum

7. Aesthetic Angles five facial aesthetic angles three are determined using the geometry of the nasal dorsum the nasofacial , the nasofrontal , and the nasomental angles.

8. Nasal Length divides the lower face into two parts using the nasion , subnasale , and menton as landmarks . Using this method, nasal length ( nasion to subnasale ) should be three fourths the distance from the subnasale to the menton .

9. NASAL VAULT DEFECTS Dorsal hump Deep nasion Saddle nose Asymmetric nasal bones Short/long nasal bones Wide/narrow bony pyramid Depressions Twists

10. Cartilaginous Vault Defects more complex than that of the bony vault because it is frequently accompanied by internal nasal deformity contributing to airway compromise

11. Cartilaginous Vault Defects hump deformity inverted-V deformity nasal valve collapse pollybeak deformity

12. Management of The Cartilaginous Vault Correction of middle vault starts with septoplasty Spreader grafts

13. Spreader grafts are placed between the junctions of the upper lateral cartilages and septum to widen and stabilize the nasal valve. Unilateral /bilateral Most spreader grafts are 1.5 to 2.5 cm in length and 1 to 3 mm in width

14. Management of The Bony Vault Surgical treatment of the bony vault should aim to accomplish the following: (a) establishment of appropriate dorsal projection (b) creation of a smooth dorsal contour free of bony irregularity (c) correction of nasal width (d) straightening of the crooked nose.

15. Hump Reduction large humps require removal with the osteotome Refinements can then be performed by rasping

16. Osteotomies Osteotomies can be performed laterally, medially, or intermediately Open roof deformity

17. Thank you