Axel Haddad1, Gauthier Dodin2, Gabriela Hossu3, Manuela Perez4, Pedro Teixeira2, Cécile Rumeau1, Roger Jankowski1, Romain Gillet5. 1. Service de Chirurgie, ORL et Cervico-faciale, CHRU de Nancy, Université de Lorraine, Nancy, France. 2. Service d'Imagerie GUILLOZ, CHRU de Nancy, Université de Lorraine, Nancy, France. 3. IADI, U1254, Université de Lorraine, Nancy, France. 4. Department of Anatomy, Université de Lorraine, Nancy, France. 5. Service d'Imagerie GUILLOZ, CHRU de Nancy, Université de Lorraine, Nancy, France. romain_gillet3@hotmail.com.
Abstract
PURPOSE: To study the anatomy of the latero-lateral joint (LLJ) between the upper lateral (ULC) and lower lateral (LLC) crus of the nasal cartilages, usually described as a scroll articulation. METHODOLOGY: Six nasal pyramids were taken in monobloc from fresh cadavers and imaged on micro-MRI with 0.4 mm slice thickness. Images were jointly interpreted by two head and neck radiologists and one surgeon. The junction between the ULC and LLC, the presence of ligaments and of sesamoid or accessory cartilages were assessed. RESULTS: Eight LLJs could be analyzed, with four types of junctions: hook-shaped cephalic border of the LLC turned towards the nasal fossa and linear caudal border of the ULC (n = 3), hook-shaped caudal border of the ULC and linear cephalic border of the LLC lateral crus (n = 1), hook-shaped border of both cartilaginous edges with clinging (n = 1) (scroll articulation) or without clinging (n = 3). No ligament or sesamoid cartilage was found, but posterior accessory cartilages were seen in 75% of the cases. CONCLUSION: The classical scroll articulation of the LLJ has been observed in only 1/8 cases on micro-MRI images. The anatomy of the LLJ could explain the surgical difficulty in raising the tip of the nose in some patients and not in others.
PURPOSE: To study the anatomy of the latero-lateral joint (LLJ) between the upper lateral (ULC) and lower lateral (LLC) crus of the nasal cartilages, usually described as a scroll articulation. METHODOLOGY: Six nasal pyramids were taken in monobloc from fresh cadavers and imaged on micro-MRI with 0.4 mm slice thickness. Images were jointly interpreted by two head and neck radiologists and one surgeon. The junction between the ULC and LLC, the presence of ligaments and of sesamoid or accessory cartilages were assessed. RESULTS: Eight LLJs could be analyzed, with four types of junctions: hook-shaped cephalic border of the LLC turned towards the nasal fossa and linear caudal border of the ULC (n = 3), hook-shaped caudal border of the ULC and linear cephalic border of the LLC lateral crus (n = 1), hook-shaped border of both cartilaginous edges with clinging (n = 1) (scroll articulation) or without clinging (n = 3). No ligament or sesamoid cartilage was found, but posterior accessory cartilages were seen in 75% of the cases. CONCLUSION: The classical scroll articulation of the LLJ has been observed in only 1/8 cases on micro-MRI images. The anatomy of the LLJ could explain the surgical difficulty in raising the tip of the nose in some patients and not in others.
Authors: Gabriel Chartrand; Phillip M Cheng; Eugene Vorontsov; Michal Drozdzal; Simon Turcotte; Christopher J Pal; Samuel Kadoury; An Tang Journal: Radiographics Date: 2017 Nov-Dec Impact factor: 5.333
Authors: Fouad Mohammed Ghareeb; Ahmed Tharwat Nassar; Ahmed Abdelaziz Talaab; Sherief Alkashty Journal: Plast Reconstr Surg Glob Open Date: 2018-10-22