Anatomical variations of the upper lateral cartilages and their implications in rhinoplasty

de Pochat VD, Alonso N, Ribeiro EB, da Rocha EA, Tenório EG, Meneses JV.

PubMed 21993578 Publisher (DOI)

What this paper says

In 32 upper lateral cartilages from 16 cadavers, total length averaged about 20.5 mm and the portion hidden under the nasal bones averaged about 4.6 mm, with a range of 2 to 7 mm that surgeons must allow for when placing spreader grafts.

Overview

The upper lateral cartilages form the sides of the middle third of the nose. Handling them during rhinoplasty can collapse that section and narrow the airway. Few studies have measured them. The authors dissected cadavers to measure their full length, the part overlapped by the nasal bones and the part below the bones.

Sections of note

Anatomical study on 32 upper lateral cartilages from 16 fresh adult cadavers; 13 male, 3 female, ages 20 to 60.
Measured with a millimeter ruler; analyzed in BioEstat 5.0 at a significance level of 0.05.
Length under the nasal bones: right 3 to 7 mm (mean 4.62, SD 1.20); left 2 to 7 mm (mean 4.56, SD 1.26).
Total length: right 16 to 28 mm (mean 20.44, SD 3.26); left 17 to 30 mm (mean 20.75, SD 3.71).
The authors relate the variation to care in fabricating spreader grafts so the dorsal lines and breathing are preserved.

What it means for a patient

The cartilage that holds the middle of the nose open varies in length by nearly a factor of two between people.
A surgeon placing spreader grafts has to size them to the individual, which this study quantifies.
Small cadaver sample, mostly male; living anatomy by ethnicity and sex is not covered.

Why this paper matters

Middle vault collapse and inverted-V deformity after hump removal come from the upper lateral cartilages losing support. Measured norms help plan spreader grafts. How these dimensions relate to airway measurements in living patients is not addressed.

Terms

Upper lateral cartilages: the paired cartilages forming the sides of the middle third of the nose, attached to the nasal bones above and the septum in the middle.
Middle vault: the cartilage section of the bridge between the nasal bones and the tip.
Spreader graft: a cartilage strip placed between the septum and an upper lateral cartilage to widen and support the middle vault.
Cephalad: toward the head; here the upper part under the bones.
Caudal: toward the tail; here the lower part below the bones.
Dorsal aesthetic lines: the paired curved highlights along the bridge seen from the front.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Upper lateral cartilage manipulation is often associated with compromise of the middle-third vault. Although the anatomical details of the upper lateral cartilages are of great importance for the maintenance or even the creation of an aesthetically pleasing dorsum with proper respiratory function, the literature…”

Excerpt; the full abstract is on PubMed.