Macroscopic and microscopic details of the cartilaginous nasal pyramid.
PURPOSE: The purpose of this investigation was to ascertain the macroscopic and microscopic details at rhinion and throughout the cartilaginous nasal pyramid in 35 white cadavers. MATERIALS AND METHODS: Demographic information on 35 white cadavers was collected. This included sex, height, weight, brief medical history, age at death, and cause of death. All soft tissues were removed from the nasal bones, lateral nasal cartilages, and alar cartilages and the overlap between bone and cartilage was measured at 4 sites. The lateral nasal cartilage (LNC) was measured for width and length. The relationship between the caudal end of the LNC, and the anterior septal angle was also noted. The septum and LNC were removed en bloc randomly from 25 of the cadavers. These specimens were fixed in formalin, processed, embedded in paraffin, and coronally sectioned every 3 mm, and prepared for microscopic examination. RESULTS: The LNC was 22.51 mm long and 13.71 mm wide on average. It underlapped the nasal bone 14.97 mm on average from the nasal septum laterally. The cephalocaudal underlapping was greatest in the midline (mean, 8.63 mm) and least (2.77 mm) about halfway down the nasal bone. Microscopic examination showed extreme variation in the attachment of the septum and LNC. This ranged from no cartilaginous connection to complete fusion. Thirty-two percent of the specimens showed the caudal edge of the LNC to be coincident with the anterior septal angle. CONCLUSIONS: At the time of aesthetic, functional, or post-traumatic nasal surgery, one must be prepared to deal with diverse attachments between the septum and the LNC.