The Importance of the Upper Lateral Cartilage in Rhinoplasty

Overview

The upper lateral cartilages are the paired cartilages forming the middle third of the nose, joining the nasal bones above to the tip cartilages below. The authors state they are instrumental in achieving good results in both appearance and breathing surgery, and that understanding their anatomy in detail lets a surgeon use their characteristics deliberately.

Sections of note

• The article is a short review, not a study of patients.
• The upper lateral cartilages are described as instrumental in both aesthetic and functional rhinoplasty outcomes.
• Four parameters are named as adjustable through them: projection, width, the shape of the nasal bridge, and tip rotation.
• The authors describe these parameters as crucial and malleable, meaning they can be changed through this part of the framework.
• A clear understanding of the anatomical detail in this part of the cartilaginous framework is stated as the requirement.
• No patient numbers, techniques with outcomes, complication rates or measured data appear in the abstract.

What it means for a patient

• The middle third of the nose does more than sit between the bones and the tip. It affects how wide the nose looks, how the bridge reads in profile, and how the tip sits.
• These same cartilages form part of the internal nasal valve, which is why work here affects breathing as well as appearance.
• Damage or over-reduction in this region is a recognised source of both a pinched appearance and blocked breathing.
• A short narrative review with no data cannot show which techniques in this region produce better results.

Why this paper matters

The middle vault is a common site of both aesthetic and functional failure after rhinoplasty, typically after a bridge hump is reduced and the roof of the nose is left open. Emphasising the region as a control point rather than a passive structure is the position taken here. It offers no measured comparison of techniques.

Terms

• Upper lateral cartilage: the paired cartilages forming the middle third of the nose.
• Middle vault: the middle third of the nose, between the nasal bones and the tip.
• Nasal dorsum: the bridge of the nose.
• Tip rotation: the upward or downward angle of the nasal tip.
• Internal nasal valve: the narrowest part of the nasal airway, formed partly by these cartilages.