Physiology of the Nasal Cartilages and Their Importance to Rhinosurgery
The complex framework of the human nasal cartilages is unique among mammals. It is the mobile portal to the respiratory system providing conditions for the passage of airstreams and for the generation of nasal resistance and turbulence. Already in utero,
- PDF / 3,136,044 Bytes
- 29 Pages / 504.57 x 720 pts Page_size
- 99 Downloads / 192 Views
34
Wolfgang Pirsig
Keywords
Nasal cartilages • Fetal nose • Physiological septal deviation • Septal abscess • Septal perforation • Septal histology • Cartilaginous fractures • Nasal valve surgery • Congenital septal deviation • Alar collapse • Septal reconstruction
Core Messages
• The complex framework of the human nasal cartilages, unique among mammals, is the mobile portal to the respiratory system providing conditions for the passage of airstreams and the generation of nasal resistance and turbulence. • The septodorsal (septolateral) cartilage is the dominating structure for nasal and midfacial growth and decisive for the appearance and several functions of the nose. Together with the erectile lining of the nasal cavities, the cartilaginous framework enables air-conditioning and the acting of the nasal cycle. • The anterior nose with the nasal valve as its crucial functional region is the narrowest part of the upper airways and
W. Pirsig, MD Department of Otorhinolaryngology, University Hospital Ulm, Mozartstrasse 22/1, Ulm, Germany, D-89075 e-mail: [email protected]
provides two-thirds of the total airway resistance. • Due to its protruding exposition, it is especially vulnerable to external injuries and may react as a protecting crumpled zone. This exposition also is the reason why most of the obstructing structures of the nasal airways are diagnosed in the anterior nose. • Long-term observations have shown that the most effective outcome after functional and aesthetic rhinosurgery is achieved by focusing on restoring the physiological functions of the anterior nose, the site of the most resistive nasal segments.
The human nose, with its prominent bridge, its elongated tip and its downturned nostrils, is unique. Besides sniffing strange odours, it acts as a vital air-conditioning unit, warming, cleaning and moistening the air we breathe in before it reaches the delicate lungs. Assisting this – and
T.M. Önerci (ed.), Nasal Physiology and Pathophysiology of Nasal Disorders, DOI 10.1007/978-3-642-37250-6_34, © Springer-Verlag Berlin Heidelberg 2013
475
W. Pirsig
476
also adding resonance to the voice – are the nasal sinuses, but the price we pay for possessing these valuable cavities is an all too common susceptibility to local infections. This precise summing up of appearance and functions of the nose including its Achilles’ heel tendon, the diseases, was published in 1985 by the zoologist Desmond Morris in his outstanding book ‘Bodywatching’ (Morris 1985). In the following chapter, I’ll focus on some functional aspects of the cartilaginous framework of the human nose with emphasis on its vulnerability and long-term results following surgical treatment. Why do we have a nose of such a protruding shape, which is divided by the septum into two parallel halves? Why is this mobile organ built up by a complex framework of hyaline cartilages and covered by muscles? Why do we need this nose at all, although we can survive by breathing through the mouth? I asked anatomists, physiologists, r
Data Loading...
