A histological study of the nasal cartilages in man (Japanese adults)

Abstract

The external nose is one of the most prominent features contributing to the attractiveness of man. A thorough grasp of the anatomy of the external nose is necessary for any operative procedure involving the nose. Yet a search of the pertinent literature has revealed few studies specifically treating the external nose, particularly regarding the nasal cartilege. Professor R. Takahashi, however, has always stressed the importance of the relationship between the external and internal nose. Our investigations have been pursued with the relationship in mind, especially those concernes with the nasal septum and the lateral nasal walls. The comparative. anatomy of the nasal cartilages in mammals (Amano) and an embryological study of the lower lateral cartilages (Okihisa) have already been reported from our department. The present study concerns the structure of the cartilaginous portion of the external nose in adult man, an area of investigation which has been partially reported elsewhere. Serial coronal and frontal sections of the external nose, procured from 19 cadavers ranging in age from 35 to 78 years, were examined. To observe the spatial relationship of the various parts of the external nose, the noses in an additional 4 cadavers were dissected and examined under magnification or with the naked eye. Cartilaginous segments not usually described in textbooks were consistently found in the region corresponding to the slanted arm of the N-shaped junction of the upper and lower lateral cartilages. These carlitaginous segments which were found on both sides symetrically, were larger than the sesamoid cartilages and more horizontally situated. This cartilage, distinctive from the sesamoid cartilage, was given the name intermediate cartilage. The designations given to the nasal cartilages differ among various investigators, but, on the basis of the results of my observations, the names proposed by R. Takahashi, shown below, appear to be the most appropriate. (Figure presented.) The inferior lateral cartilages described by some as contributing to the framework of the alar portions did not appear as supporting structures of this portion of the nose in my studies. At the junctions of the nasal bone and cartilage or between the cartilages, considerable overlapping of the edges was observed. Especially, the latero-inferior edge of the superior lateral cartilage was found inserted below the corresponding edge of the inferior lateral cartilage with few exceptions. This was also true at the junction of the nasal bone and cartilage, and the two were firmly connected by connective tissue. The inferior edge of the superior lateral cartilage possessed numerous indentations or slits extending for a considerable distance superiorly. These were not visible to the naked eye but were seen easily under magnification. These slits were observed by Strastma to extend up to 2/3rds of the length of the cartilage but were found only as far as the lower 1/3rd of the cartilage in my study. In addition, the complicated form described by the antero-inferior edge of the superior lateral cartilage appears to be greatly influenced by the form of the supra-alar sulcus and the development of the nasal septum. The results of this study concerning the relationships and forms of the various components of the nasal pyramid imply that the external nose is not a simple structure of various tissues but an organic structure with the main purpose of maintaining the airway. © 1974, Society of Oto-rhino-laryngology Tokyo. All rights reserved.