Vascular Anatomy on the Nasal Tip in Koreans / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: The blood supply of the nasal tip and columella was examined to determine whether the blood supply to the nasal tip could be damaged from transcolumellar incision during an external rhinoplasty approach in Koreans. MATERIALS AND METHODS: The blood vessels that supply the nasal tip were examined by dissecting 51 cadavers, and their corresponding 102 nasal sections were injected with red latex prior to the dissection. The size and distribution of the vessels were measured with unaided eyes to determine the primary supplying vessels. The subdermal layer in which the vessels lie and the course of the vessels were also investigated. RESULTS: The main vessels of the nasal tip proved to be the lateral nasal artery (78%) and the dorsal nasal artery (22%). Columellar branches were narrower in diameter than the lateral nasal and dorsal nasal arteries and varied in their size and appearance, and therefore they appeared insufficient to be main vessels to supply blood. These arteries passed through the musculoaponeurotic layer, but they were also close to the main surgical plane in the dome of the lower lateral cartilage. CONCLUSIONS: We speculate that the blood supply to nasal tip in Koreans is primarily derived from the lateral nasal or dorsal nasal arteries, with variable contribution from the columellar arteries. Therefore, it is the most important to determine the surgical plane below the musculoaponeurotic layer in order to prevent necrosis of skin flap or deformity due to damage of vessels in the case of external rhinoplasty.