Anatomy of the Nose
The normal anatomy of the nose is shown in Figures 1-3: the various terms used for nasal structures and dimensions (Fig. 1), the cartilaginous components of the nose and terms for regions (Fig. 2), and in Figure 3 the cross section is shown.
Figure 1
Figure 2
Figure 3
Some anatomical landmarks deserve specific mention as these are not always used with standard meaning.
- Nasal Root:
- The most depressed, superior part of the nose along the nasal ridge.
- Nasion:
- The midline point just superior to the nasal root overlying the naso-frontal suture.
- Nasal Bridge:
- A saddle-shaped area that includes the nasal root and the lateral aspects of the nose. It lies between the glabella and the inferior boundary of the nasal bone, and extends laterally to the inner canthi.
- Nasal Ridge:
- The midline prominence of the nose, extending from the nasal root to the tip (also called the dorsum of the nose).
- Nasal Base:
- An imaginary line between the most lateral points of the external inferior attachments of the alae nasi to the face.
- Nasal Tip:
- The junction of the inferior margin of the nasal ridge and the columella. Commonly, it is the part of the nose furthest from the plane of the face. In rare circumstances, such as markedly prominent and convex nasal profiles, other parts of the ridge may be further removed from the facial plane.
- Ala:
- The tissue comprising the lateral boundary of the nose, inferiorly, surrounding the naris.
- Columella:
- The tissue that links the nasal tip to the nasal base, and separates the nares. It is the inferior margin of the nasal septum.
Measurements of the Nose
Measurements of the nose are possible using sliding calipers. The reliability of measurements using a tape measure is poor. Furthermore, the actual position of several of the landmarks may preclude accurate measurement. For example, if the nasal tip overhangs the upper lip, the position of subnasale is difficult to define [Hall et al., [2007]]. Nasal length and width are the most common measurements taken in practice. A short description of how to measure each dimension is provided as the various terms are defined.
Growth of the nose does not end at puberty: the nose continues to increase in size with age. There are no normal standards for nasal size in adulthood.
The reader is referred to the Handbook of Normal Physical Measurements [Hall et al., [2007]] for detailed descriptions of measurement techniques, additional nasal measurements not described here, and growth standards. Most are available for Caucasians of Northern European extraction only, and similar standards for other ethnicities are urgently needed.
Anatomical Variation
Anomalies of the nose may be classified into quantitative traits and qualitative features:
- Variations in length: long; short
- Variations in width: wide nose; narrow nose, broad nasal base; narrow nasal base; broad nasal tip; narrow nasal tip; wide nasal ridge; narrow nasal ridge; wide nasal bridge; narrow nasal bridge; broad columella.
- Variations in length and width: prominent nose; absent nasal cartilage; absent nose.
- Variations in shape or position: depressed nasal bridge; depressed nasal ridge; depressed nasal tip; bulbous nose; bifid nasal tip; bifid nose; overhanging nasal tip; deviated nasal tip; fullness of paranasal tissue; prominent nasal bridge; convex nasal ridge; concave nasal ridge; low insertion of the columella; low hanging columella; short columella; high insertion of the columella; thick ala nasi; underdeveloped ala nasi; cleft ala nasi; enlarged naris; narrow naris; single naris; proboscis; supernumerary naris; anteverted nares.