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Alar Base Surgery
Published in Suleyman Tas, Rhinoplasty in Practice, 2022
Soft tissue anatomy of the alar base contains static and dynamic components. The pyriform ligament is the most important structure of the static component (Figure 5.18). The dynamic component of the alar base contains four muscle groups which are depressors, elevators, compressors, and dilators. The most important of them, which determines the position of the alar base, is the levator alaeque nasi muscle (LANM). This muscle originates from the frontal process of the maxillary bone and passes caudally along the base line of the nose, dividing into the medial and lateral before adhesion. The medial part adheres to the lateral nostril while the lateral part adheres to the orbicularis oris muscle. Therefore, shortness of this muscle may affect the upper lip (Figure 5.19).
Head and Neck Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Warrenkevin Henderson, Hannah Jacobson, Noelle Purcell, Kylar Wiltz
Orbicularis oculi is comprised of orbital, palpebral, and lacrimal parts and a ciliary bundle (Standring 2016). The fibers of the orbital part form complete ellipses around the orbit and originate from the nasal part of the frontal bone, the frontal process of the maxilla, and the medial palpebral ligament (Standring 2016). These fibers form depressor supercilii (Macalister 1875; Standring 2016). The fibers of the palpebral part originate from the medial palpebral ligament, course across the eyelids, and end as the lateral palpebral raphe (Standring 2016). The fibers of the lacrimal part originate from the lacrimal bone and insert into the tarsi of the eyelids and the lateral palpebral raphe (Standring 2016).
Nose
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Dario Bertossi, Fazıl Apaydın, Paul van der Eerden, Enrico Robotti, Riccardo Nocini, Paul S. Nassif
The bony nasal vault comprises the paired nasal bones and the ascending frontal process of the maxilla. This part of the nose is pyramidal in shape, the narrowest portion being at the intercanthal line. The average length of the nasal bone is 25 mm; although there may be both individual and significant ethnic variation (African American noses often have short nasal bones). Laterally the nasal bones join with the frontal process of the maxilla.
In vivo analysis of endocanalicular light pipe transillumination in endoscopic dacryocystorhinostomy: Anatomic considerations and cautions for the transitioning
Published in Orbit, 2022
Nina S. Boal, Elizabeth A.Z. Cretara, Benjamin S. Bleier, Allen C. Lam, Daniel R. Lefebvre
The maxillary line is an endonasal mucosal projection that courses from the anterior middle turbinate attachment down along the lateral nasal wall to the dorsum of the inferior turbinate. It corresponds to the suture between the frontal process of the maxilla and lacrimal bone extranasally, and to the root of the uncinate process intranasally.8 The maxillary line is regarded as a reliable landmark from which to identify the location of the lacrimal sac along the lateral nasal wall during endo-DCR,8–12 along with the axilla and operculum of the middle turbinate.19 Nonetheless, placing a light pipe into the lacrimal sac to guide placement of the osteotomy is thought to be a helpful crutch for the surgeon transitioning to endoscopic technique as the individual becomes familiarized with intranasal anatomy.7,14 The use of a transillumination target was first described by Christensen in 1951,13 re-introduced by Massaro in 1990,5 and was subsequently widely reported as a useful technique in endo-DCR.6,7,11,12,14
Current management strategies of congenital nasolacrimal duct obstructions
Published in Expert Review of Ophthalmology, 2021
Silvana Artioli Schellini, Victoria Marques-Fernandez, Roberta Lilian Fernandes Sousa Meneghim, Alicia Galindo-Ferreiro
This technique is also similar to the technique used in adults, except the instruments are more delicate due to the reduced dimensions of the nasal fossa. The middle meatus is reached using a 2.7 mm 0° rigid nasal endoscope. After infiltration of local anesthetic associated with a vasoconstrictor, the lateral nasal mucosa is opened using a sickle knife or a blade, starting from the front of the uncinate process near the maxillary line and moving downward, reaching the periosteum. The frontal process of the maxilla is removed, and then the medial lacrimal sac wall is exposed and opened. The lacrimal sac can be marsupialized or the medial portion of the lacrimal sac can be removed. A stent can be inserted, but it does not improve the success rate (Figure 4A-D).
High-resolution computed tomography assessment of bony nasolacrimal parameters: variations due to age, sex, and facial features
Published in Orbit, 2021
Zhiheng Lin, Namita Kamath, Adeela Malik
The majority of NLDs have an oval configuration, with a greater diameter AP compared to transverse at the narrowest points, suggesting that transverse diameter is most important in flow limitation. In only 12 NLDs were the transverse measurements greater than the AP, and in 4 NLDs they were equivalent (i.e. a circular NLD). A greater value in any NLD measure correlated very strongly (p < .001) positively with any other NLD measure except for length, e.g. a larger entrance area correlates with a larger exit and larger minimum diameters. Our results showed a significant correlation between longer NLDs and larger exits of the NLD, but narrower minimum AP diameters, suggesting longer NLDs have a more hourglass rather than cylindrical shape, and are perhaps more prone to obstruction as a result. We also found a wider upper face correlates with a wider nose but more importantly with a larger NLD, which agrees with previous work in multiple races also using the inter-frontozygomatico suture distance as a landmark.12 Kang et al. found taller noses relate to a thinner frontal process of the maxilla in Koreans, but another study found no such link, nor in this study.5,11 We found a thicker frontal process of maxilla correlated only with a larger NLD entrance. This study reveals that a taller nose correlates significantly with a narrower NLD, at the entrance, exit, and minimum transverse diameter. This has not been published before.