By R.L. Nussbaum, R.L Molness
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They also serve as important landmarks for sinus surgery. In rhinoplasty, contact with the turbinates is largely avoided in order to prevent bleeding. The inferior turbinate is useful in osteotomies – mucosal incisions for osteotomies are placed just superior to the inferior turbinate to allow access to the pyriform aperture. Also, the middle turbinate serves as a landmark for the sphenopalatine ganglion, which is an important consideration in nerve blocks for complete intranasal anesthesia. Fig.
15 The Lateral Nasal Wall . . . . . . . . . . . . . . . . . 15 Inferior Turbinate . . . . . . . . . . . . . . . . . . . 15 Middle Turbinate . . . . . . . . . . . . . . . . . . . . 15 Superior and Supreme Turbinates . . . . . . . . . . . . . 16 Classical anatomy of the nasal cavity and paranasal sinuses was elucidated originally by elegant gross dissection, and more recently with even greater resolution facilitated by modern imaging.
It is for this reason that it is imperative to take preoperative photographs, analyze the patient’s aesthetics, and realistically alter their photographs to create improvements. Once the aesthetics have been analyzed, the surgeon should have an accurate conception of the underlying anatomy, and the surgical plan. Nasal anatomy can be subdivided into several categories including the skin-soft tissue envelope (S-STE), septum, lateral nasal walls, bony pyramid, cartilaginous vault, and nasal tip. Surgical Anatomy of the Nose The external areas of the nose can be further broken down into aesthetic subunits: the dorsum, side-walls, columella, soft tissue triangle, ala, and tip.