• Archives of Plastic Surgery
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• v.38 no.5
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• pp.669-673
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• 2011

Purpose: The authors have conducted a series of anatomic studies on the factors affecting shape of a lower vault in Asian noses. The results of the studies showed that prominence of alar lobule is mainly affected by the volumes of the dilator naris anterior and posterior muscles and the insertions of the dilator naris posterior muscles. However, information on its clinical availability is yet insufficient. The present study was undertaken for clinical purpose to find out the effect of dilator naris muscle resection on the correction of prominent alar lobule. Methods: Six patients who were treated by dilator naris muscle resection with a long-term follow-up of more than 1 year were involved in this study. Rhinoplasties were performed via endonasal approaches with resecting dilator naris anterior and posterior muscles by sharp scissor. The effect of the dilator naris muscle resection on alar prominence was investigated by measuring ratio of the short axis to the long axis of a nostril (SA/LA) pre-and postoperatively. The visual analog scale (VAS) was also used to evaluate satisfaction of patients. An average follow-up time was $15.6{\pm}3.7$ months. Results: Having lost the dilating and lateral pulling effects of the dilator naris muscles, the alar lobule shifted medially and alar lobule shapes improved. SA/LA significantly improved (preoperatively $0.71{\pm}0.11$ and postoperatively $0.58{\pm}0.08$; $p$ <0.05). The VAS score was also increased postoperatively (preoperatively $3.2{\pm}1.8$ and postoperatively $8.7{\pm}1.2$; $p$ <0.05). A mild degree of hyperpigmented scar was noted in one alar lobule. Otherwise, there was no case of postoperative complication. Conclusion: Our results suggest that prominent alar lobule could be modified by resecting the attachment of the dilator naris muscles. This maneuver removes the function of dilator naris muscles, then may produce a more aesthetically acceptable alar lobule shape.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.269-275
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• 2006

This study is to provide details of the unique anatomical features on the alar lobule region in Korean nose. We hypothesized that the anatomy of this area differs according to the shape of the alar lobule. Based on the prominence and roundness of alar lobules, they were classified into horizontal and vertical types. A total of 20 fresh cadaver noses(10 for each type) were dissected. The anatomical differences between the horizontal and vertical types were investigated by gross and histologic studies. The alar lobule is composed of three layers, i.e., external skin, muscle, and vestibular skin. Profound differences between the two alar lobule types were evident in terms of the volume of the dilator naris anterior muscle, the insertion of the dilator naris posterior muscle, and the thickness of the external skin at the lateral end of the alar circumference. The horizontal type has a greater volume of dilator naris anterior muscle, an additional insertion of the dilator naris posterior muscle, and thicker external skin at the lateral end of the alar circumference than the vertical type. The Korean nose differs anatomically and morphologically from the Caucasian nose. This study shows that there are anatomic differences between the horizontal and vertical types of alar lobules in Korean nose.

• The korean journal of orthodontics
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• v.20 no.1
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• pp.47-59
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• 1990

Respiration is one of the most important functions which are carried out in stomatognathic system. When nasal orifice is obstructed or the resistance of upper airway is increased mouth breathing is initiated. Mouth breathing is regarded as an important etiologic factor of dentofacial anomalies. This experiment was performed to observe the influences of metabolic acidosis, tracheal resistance and vagotomy on mouth breathing. After rabbits were anesthetized with sodium pentobarbital, a pair of wire electrode was inserted into mylohyoid muscle, anterior belly of digastric muscle and dilator naris muscle to record EMG activity. Femoral vein and artery were cannulated for infusion of 0.3N HCl and collection of blood sample to determine the blood pH, and tracheal intubation was done to control airway resistance. Mouth breathing was induced by metabolic acidosis. Increase of the airway resistance through tracheal cannula intensified the activity of dilator naris, mylohyoid and digastric muscle. The higher the resistance, the larger the EMG amplitude. After bilateral vagotomy, respiratory volume and inspiatory time were increased and the activities of dilator naris, mylohyoid and digastric muscle were strengthened. It was concluded that the muscle activity related to mouth breathing was induced by metabolic acidosis and increase of tracheal tube resistance.