코의 "진피연골인대"의 해부학

Anatomy of Pitanguy's Dermocartilaginous Ligament

  • 박덕준 (고려대학교 의과대학 성형외과학교실) ;
  • 한승규 (고려대학교 의과대학 성형외과학교실) ;
  • 정성호 (고려대학교 의과대학 성형외과학교실) ;
  • 김우경 (고려대학교 의과대학 성형외과학교실)
  • Park, Doug John (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Han, Seung-Kyu (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Jeong, Seong Ho (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Kim, Woo Kyung (Department of Plastic Surgery, Korea University College of Medicine)
  • 투고 : 2006.10.19
  • 발행 : 2007.03.10

초록

Purpose: Pitanguy conducted a series of anatomical studies on "dermocartilaginous ligament" of the nose. However, information on its structure is as yet insufficient, especially in terms of its origin, insertion, and relationships with surrounding tissues. In addition, some of the histologic findings described by Pitanguy are controversial. The present study was undertaken to clarify the anatomy of the "dermocartilaginous ligament". Methods: Sixteen cadaver noses were examined macroscopically and histologically to determine the presence, origin, insertion, composition, and relationship of the "dermocartilaginous ligament" with surrounding structures. Results: The structure originated from the deep layer of the transverse nasalis muscle and terminated at the caudal edge of the septal cartilage in all 16 cadavers. However, in three cadavers the insertion extended to the orbicularis oris muscle. No direct connection was found between the structure and dermis of dorsal nasal skin. The dermocartilaginous ligaments were mainly composed of a condensation of thin collagen bundles, which were interwoven and without any regular orientation. Elastic fibers were also present in small numbers, and there were few amorphous ground substances. Neither muscle fibers nor chondrocytes was identified within dermocartilaginous ligaments. Conclusion: Our macroscopic and histologic findings of the structure do not support the use of the term "dermocartilaginous ligament". According to its origin, insertion, and histologic findings, we recommend that this structure be referred to as the "median musculocartilaginous fascia".

키워드

참고문헌

  1. Pitanguy I: Surgical importance of a dermocartilaginous ligament in bulbous noses. Plast Reconstr Surg 36: 247, 1965
  2. Pitanguy I, Salgado F, Radwnski, HN, Bushkin SC: The surgical importance of the dermocartilaginous ligament of the nose. Plast Reconstr Surg 95: 790, 1995
  3. Pitanguy I: Revisiting the dermocartilaginous ligament. Plast Reconstr Surg 107: 264, 2001
  4. Hwang K Kim DJ, Hwang G: Relation between depressor septi nasi muscle and dermocartilaginous ligament; anatomic study and clinical application. J Craniofac Surg 17: 286, 2006 https://doi.org/10.1097/00001665-200603000-00015
  5. McCollough EG: Surgery of the nasal tip: Prudent selection of alternatives. In Daniel RK: Aesthetic Plastic Surgery: Rhinaplasty. Boston, Little Brown & Co., 1993, P 415
  6. Oneal RM, Izenberg PH, Schlesinger J: Surgical anatomy of the nose. In Daniel RK: Aesthetic Plastic Surgery: Rhinaplasty. Boston, Little Brown & Co., 1993, P 16
  7. De Souza Pinto EB, De Rocha RP, Filho WQ Neto ES, Zacharias KG, Amancio A, Braz de Camargo A: Anatomy of the median part of the septum depressor muscle in aesthetic surgery. Aesthetic Plast Surg 22: 111, 1998
  8. Song K Ma H, Pan F: The 'levator septi nasi muscle' and its clinical significance. Plast Reconstr Surg 109: 1707, 2002
  9. Leeson TS, Leeson CR, Paparo AA: Text/atlas of Histology. Philadelphia, Saunders, 1988, p 126
  10. Zhai LJ, Bruintjes TD, Boschma T, Huizing EH: The interdomal ligament does not exist. Rhinology 33: 135, 1995