External Nasal Research Articles

Establishment of a surface model for 3D external nasal morphology

目的 构建解剖特征清晰的三维外鼻形态表面模型,为建造鼻缺损修复计算机辅助设计/计算机辅助制作系统(computer aided design/computer aided manufacture,CAD/CAM)用于可视化数字鼻型库奠定基础.方法选择1例老年女性的外鼻三维点云数字模型为研究对象,将外鼻按照解剖形态分为6个区,即鼻梁区、鼻尖鼻小柱区、左鼻背区、右鼻背区、左鼻翼鼻孔区、右鼻翼鼻孔区,分别在0.25、0.50、0.75、1.00 mm 4种点距时简化数据构面.选择最接近外鼻形态的构面参数.结果当点距为0.50 mm时既可以简化数据,又可以清晰展现外鼻的解剖特征及老化状态.结论合理的数据分区与适当的参数选择,可以获取解剖结构清晰的三维外鼻形态曲面模型,这对开发颜面缺损修复CAD/CAM系统具有重要意义。

Anatomy of the External Nasal Nerve

Anatomy of the External Nasal Nerve

Anatomy of the external nasal nerve.

After rhinoplasty, many patients report numbness of the nasal tip. This is primarily because of injury to the external nasal nerve. It is imperative that surgeons performing rhinoplasty be familiar with the anatomy and the common variations of this nerve. Therefore, the purpose of this study was to present an anatomical study of the external nasal nerve. Twenty external nasal nerves were examined by dissecting 10 fresh cadaver noses within 48 hours of death. On dissection, the exit of the nerve between the nasal bone and upper lateral cartilage was identified. The distance from the point of exit to the midline of the nose and the size of the nerve were measured. The course and the running plane of the nerve were investigated. The nerve branchings were also classified into three types: type I, only one nerve without any branch; type II, one nerve proximally and then splitting into two main branches at the intercartilaginous junction; and type III, two main branches from the point of exit. The point of exit of the external nasal nerve from the distal nasal bone was located 6.5 to 8.5 mm (7.3 +/- 0.6 mm) lateral to the nasal midline. The average diameter of the nerve at the point of exit was 0.35 +/- 0.036 mm. Most of the nerves (95 percent) passed through the deep fatty layer directly under the nasal superficial musculoaponeurotic layer, all the way down to the alar cartilages. In terms of the branching type, type I was observed in 10 of 20 nerves (50 percent), type II was observed in six of 20 (30 percent), and type III was seen in four of 20 (20 percent). On the basis of the results of this study, the following precautions are suggested during a rhinoplasty to minimize the chance of injury to this nerve. First, it is best to avoid deep intercartilaginous or intracartilaginous incisions so that the deep fatty layer is not invaded and the dissection is maintained directly on the surface of the cartilage (deep to the nasal superficial musculoaponeurotic layer). Second, dissection at the junction of the nasal bone and upper lateral cartilage area of one side should be limited to within 6.5 mm from the midline. Lastly, when the nasal dorsum is augmented by an onlay graft, implants or grafts less than 13 mm wide at the rhinion level should be used.

Alterations in nasal sensibility following open rhinoplasty

Alterations of nasal sensibility following open rhinoplasty were studied both subjectively and objectively. In a prospective study, 25 patients were included. All patients underwent open rhinoplasty using a middle columellar incision. Subjective questioning and objective testing of nasal sensibility using the Semmes-Weinstein monofilaments were obtained preoperatively and both 3 weeks and 1 year after surgery. The match-paired Student's t-test was used for statistical analysis. At 3 weeks after surgery, there was subjective and significant objective alteration of sensibility in the area of skin supplied by the external nasal nerve (nasal tip and adjacent upper columella). This altered sensibility, however, recovered by 1 year after surgery. The recovery was thought to be due either to recovery of the external nasal nerve itself, or to collateral sprouting from the nerves supplying the adjacent areas of nasal skin.

Post-traumatic external nasal neuralgia—an often missed cause of facial pain?

Pain about the bridge of the nose is often a diagnostic dilemma. There is an important recognizable subgroup who may, as a consequence of involvement of the external nasal nerve in nasal injury, exhibit neuralgic pain after a latent interval. Temporary relief by anaesthesia can be achieved and cure is possible by division of the anterior ethmoidal nerve. This rare cause of facial pain is presented using two illustrative cases.

Extrinsic nerve supply of the naked rhinarium in the tree shrew.

The extrinsic nerve supply of the median strip of skin in the naked rhinarium of the tree shrews (Tupaia glis) was studied by means of nerve section. Experiments were designed, where the external nasal nerves, infraorbital nerves or a combination of both were sectioned. The cholinesterase and silver impregnation techniques were employed to demonstrate intraepithelial nerves, mammalian end-organs, and the dermal nerve plexus before and after denervation. These experiments have given results contrary to what was expected, as the skin in this region, which develops from the frontonasal process, was found to be supplied by the infraorbital nerves (branches of the maxillary division of the fifth cranial nerve, which is the nerve of the maxillary process) and not the external nasal nerves (branches of the ophthalmic division of the fifth cranial nerve, the nerve of the frontonasal process).

Somatotopic organization of the trigeminal ganglion in the rat

Forty adult rats underwent simple transection of one of ten different branches of the maxillary and mandibular nerves. All animals were killed on the tenth postoperative day and the trigeminal ganglia were removed for routine histological processing. After staining for Nissl substance, the positions of chromatolytic perikarya were plotted on overlays of photographic enlargements of serial sections. The percentages of chromatolytic cells for all ganglion regions and all nerve lesions were determined and used to construct histograms. Results showed a series of somatotopic columns arranged longitudinally within the ganglion. The laterally placed cell columns corresponded to lateral fields of orofacial innervation supplied by the auriculo-temporal nerve and branches to the molar teeth. The antero-medial cell columns corresponded to more medial orofacial structures, supplied by the maxillary incisor and external nasal nerves. The dorso-ventral organization was more complex although, in general, intraoral structures were represented in the more ventral nerve-cell masses.

Subcutaneous neurotomy of the external nasal nerve for persistent pain and TIC. Report of a case

The LaryngoscopeVolume 42, Issue 7 p. 544-551 Article Subcutaneous neurotomy of the external nasal nerve for persistent pain and TIC. Report of a case Dr. Edward F. Ziegelman, Dr. Edward F. Ziegelman San FranciscoSearch for more papers by this author Dr. Edward F. Ziegelman, Dr. Edward F. Ziegelman San FranciscoSearch for more papers by this author First published: July 1932 https://doi.org/10.1288/00005537-193207000-00005AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume42, Issue7July 1932Pages 544-551 RelatedInformation

The Therapeutic Value of Laceration of the External Nasal Nerve

The Therapeutic Value of Laceration of the External Nasal Nerve