The Correlation between the Structures of the Nasal Tip on the Ultrasound and the Anthropometry of the Nose in Vietnamese.

BACKGROUND: Nowadays, there are few types of research held in Vietnam to investigate the anthropometric index of the nose as well as analysis the structure of nasal tip on ultrasound to identify the relationship between these parameters. AIM: To determine the relationship between the height and the width of the nasal tip and the structures constructed these areas by anthropometric and ultrasound measurement. METHODS: A descriptive study in Thanh Van Hospital from December 2017 to April 2019. RESULTS: There were 94 women (62.7%), and 56 men (37.3%) and the average age were 33.6 years old. The height and width of the nasal tip are 10.1 mm and 21.7 mm, respectively. Through the ultrasound, the thickness of the adipose tissues is 3 mm. The width of the interdomal fat pad is 6.5 mm and the distance between two tip point is 5.6 mm. There are the relationships between the distance of two tip points and the width of the tip (r = 0.341), and the width of the interdomal fat pad (r = 0.72). There is also the correlation between the width of the nasal tip with the distance of two tip points (r = 0.46) and the height of the tip with the thickness of the interdomal fat pad (r = 1.23). CONCLUSION: The thickness of the interdomal fat affects the height of the tip, and the distance of two tip points influences the width of the tip.

Modificaciones de la punta nasal posterior a rinoplastia transcartilaginosa / Modifications of Nasal Tip After Transcartilaginous Rhinoplasty

Introducción: La reducción del ancho y definición de la punta nasal es uno de los objetivos principales de la rinoplastia estética. La vía endonasal, con incisión transcartilaginosa, se emplea principalmente cuando no hay alteraciones significativas en la estructura cartilaginosa de la punta nasal. Objetivo: Determinar los cambios morfológicos que se producen en la punta nasal, posterior a la rinoplastia transcartilaginosa. Métodos: Se realizó un estudio descriptivo, prospectivo, longitudinal en 15 pacientes con deformidad estética de la punta nasal, operados por rinoplastia transcartilaginosa en el Hospital "Hermanos Ameijeiras", entre el 2016 y el 2020. Las variables estudiadas fueron: ángulo nasolabial, ancho de la punta nasal, porciento de reducción del ancho de la punta nasal, relación longitud nasal-proyección de la punta nasal y estado de satisfacción de los pacientes. Resultados: Se produjo un estrechamiento de la punta nasal, de una media del ancho preoperatorio de 64,8 por ciento con relación a la base nasal, a una media del 60,1 por ciento para el posoperatorio, para una media del porciento de reducción del ancho de la punta nasal posoperatoria de 7,3 por ciento. En el resto de las variables estudiadas, aun cuando existieron cambios individuales, como grupo no hubo variación respecto al predominio de las categorías ideales. Conclusiones: Se produjeron modificaciones posoperatorias que tributaron en un refinamiento de la punta nasal, con un alto grado de satisfacción de los pacientes operados. Palabras clave: rinoplastia endonasal; modificación de la punta nasal; mediciones antropométricas(AU)

Introduction: The reduction of the width and definition of the nasal tip is one of the main objectives of aesthetic rhinoplasty. The endonasal route, with a transcartilaginous incision, is mainly used when there are no significant alterations in the cartilaginous structure of the nasal tip. Objective: To determine the morphological changes that occur in the nasal tip after transcartilaginous rhinoplasty. Methods: A descriptive, prospective, longitudinal study was carried out in 15 patients with aesthetic deformity of the nasal tip, who were operated by transcartilaginous rhinoplasty at Hermanos Ameijeiras Hospital, from 2016 to 2020. The variables studied were nasolabial angle, width of the nasal tip, percentage of reduction in the width of the nasal tip, relationship between the nasal length and the projection of the nasal tip, and the patients' satisfaction status. Results: There was a narrowing of the nasal tip, starting from a preoperative mean width of 64.8 percent in relation to the nasal base, to a postoperative mean of 60.1 percent, resulting in a mean percentage reduction in width of the postoperative nasal tip of 7.3 percent. No variation was observed regarding the predominance of the ideal categories in the rest of the variables studied, even when there were individual changes, as a group. Conclusions: Postoperative modifications were produced that contributed to a refinement of the nasal tip, with a high degree of satisfaction of the operated patients(AU)

An Anatomic Study of the External Nasal Nerve

After rhinoplasty, numbness of the nasal tip has been reported by many surgeons. The nasal tip receives its main sensory nerve supply from the external nasal nerve. However, investigations of the external nasal nerve have not been previously studied. Therefore, anatomic study of the external nasal nerve was performed. Twenty external nasal nerves were dissected in 10 fresh cadaver noses. On dissection, the exit of the nerve between nasal bone and upper lateral cartilage was identified, and the distance from the point of exit to the midline of the nose was measured. The course and the running plane of the nerve were investigated. The nerve branching was also classified into type I; having only 1 nerve without any branch, type II; having 1 nerve proximally, then splitting into 2 main branches, and type III; having 2 main branches from the point of exit. The point of exit of external nasal nerve from distal nasal bone was located 6.5 to 8.5 mm lateral to nasal midline. Nineteen nerves(95%) run in the same deep fatty layer all the way down to the alar cartilages, but one nerve coursed medially between both medial crura. Regarding the branching type of the nerves, type I was found to be the most common, in 10 of 20 nerves. Type II was observed in 6 and type III was seen in 4. Based on our results, the followings are suggested during a rhinoplasty. First, it is best to avoid deep inter- or intracartiaginous incisions. Instead, the dissection should be maintained directly on the surface of the cartilage. Second, dissection at the junction of nasal bone and upper lateral cartilage area of one side should be limited within 6.5mm from midline. Lastly, when the nasal dorsum is augmented by onlay graft, implants or grafts less than 13 mm wide at rhinion level should be used.