Craig John R, Bied Adam, Landas Steve, Suryadevara Amar
Syracuse, N.Y. From the Departments of Otolaryngology and Pathology, State University of New York Upstate Medical University.
Plast Reconstr Surg. 2015 Feb;135(2):406-411. doi: 10.1097/PRS.0000000000000918.
The upper lateral cartilages underlie the nasal bones cephalically, and articulate with the nasal septum medially. The authors studied the histologic and anatomical relationships between the lateral aspect of the upper lateral cartilages and the frontal process of the maxilla.
Six cadaver noses were dissected by open rhinoplasty to expose the upper lateral cartilages bilaterally. Subperiosteal dissection was performed over the medial maxillae and nasal bones to expose the perimeter of the pyriform aperture. Twelve sides were analyzed anatomically. Three cadavers were used to create six tissue specimens for histologic analysis, by resecting the tissue of the upper lateral cartilage-maxillary bone articulation en bloc.
Grossly in all specimens, the upper lateral cartilage articulated with the frontal process of the maxilla laterally, lying deep to the coronal plane of the maxillary bone. In four histologic specimens, the upper lateral cartilage was found to underlie the frontal process of the maxilla laterally, displaying an overlapping relationship. In the other two histologic specimens, the upper lateral cartilage ended medial to the maxilla. In all specimens, the ends of the upper lateral cartilage and maxilla articulated by way of a pyriform ligament.
The upper lateral cartilage articulates laterally with the frontal process of the maxilla by means of the pyriform ligament, with a variable amount of overlap between the upper lateral cartilage and maxilla. Relationships among the upper lateral cartilage, maxilla, and pyriform ligament affect the configuration of the lateral internal nasal valve area, and should be considered when planning internal nasal valve reconstruction.
上外侧软骨在鼻骨下方头侧，在内侧与鼻中隔相连。作者研究了上外侧软骨外侧与上颌骨额突之间的组织学和解剖学关系。
通过开放式鼻整形术对6具尸体鼻进行解剖，双侧暴露上外侧软骨。在双侧上颌骨内侧和鼻骨上进行骨膜下剥离，以暴露梨状孔的周边。对12侧进行解剖分析。使用3具尸体制作6个组织标本进行组织学分析，通过整块切除上外侧软骨-上颌骨连接处的组织。
在所有标本中，大体上可见上外侧软骨在外侧与上颌骨额突相连，位于上颌骨冠状平面的深面。在4个组织学标本中，发现上外侧软骨在外侧位于上颌骨额突下方，呈现重叠关系。在另外2个组织学标本中，上外侧软骨在上颌骨内侧终止。在所有标本中，上外侧软骨和上颌骨的末端通过梨状韧带相连。
上外侧软骨通过梨状韧带在外侧与上颌骨额突相连，上外侧软骨与上颌骨之间存在不同程度的重叠。上外侧软骨、上颌骨和梨状韧带之间的关系影响鼻内阀外侧区域的形态，在计划鼻内阀重建时应予以考虑。
