Do the upper lateral nasal cartilages exist? The concept of septolateral cartilages

Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Mar;138(2):77-81. doi: 10.1016/j.anorl.2020.06.017. Epub 2020 Nov 2.

Abstract

Background: In the cartilaginous nose, classical surgical anatomy describes 2 triangular upper lateral cartilages (ULCs) framing the lateral sides of the mid-third of the nasal pyramid, which articulate with to the superior edge of the quadrangular cartilage (QC) of the nasal septum. This anatomic arrangement in 3 distinct cartilage parts is, however, controversial.

Objective: The present study aimed to describe the articulation between the ULCs and the QC, avoiding dissection artefacts.

Materials and methods: Six nasal pyramids were taken in monobloc from fresh cadavers and imaged on micro-MRI with 0.4mm slice thickness. Images were interpreted jointly by 2 head and neck surgeons and a radiologist.

Results: The cartilage skeleton supporting the mid-third of the nasal dorsum in all specimens presented as 2 septal plates backing onto the midline and curving on either side to form a continuous dome under the inferior aspect of the piriform aperture.

Conclusion: Like the alar cartilages framing the tip of the nose, there are two continuous septolateral cartilages (SLCs) framing the mid-third of the nasal pyramid, likewise showing 2 cruras, medial and lateral, joined in a dome. The SLCs (also known as triangular cartilages) thus cannot be separated as 2 individual anatomic structures. These findings are in line with the shared embryological origin of all the elements composing the fibrocartilaginous nose in evo-devo theory.

Keywords: Internal nasal valve; Nasal cartilage; Rhinoplasty; Septoplasty.

MeSH terms

  • Cadaver
  • Dissection
  • Humans
  • Nasal Cartilages* / surgery
  • Nasal Septum / diagnostic imaging
  • Nasal Septum / surgery
  • Nose / surgery
  • Rhinoplasty*