Anatomical Study of the Chinese Nasal Keystone Region

The keystone region is an important anatomical structure to consider in rhinoseptoplasty, because there are few published data regarding the keystone region in Chinese noses.

The authors sought to describe the anatomy of the Chinese nasal keystone region and provide useful knowledge for rhinoseptoplasty.

Sixteen cadaveric heads (11 males, 5 females) were dissected, measured, and then compared with previously published data.

Both the nasal bone caudal margin and nasal bone-upper lateral cartilage overlapping area displayed 5 distinct shapes, and the upper lateral cartilage showed 4 distinct shapes. The nasal bone-upper lateral cartilage overlap was 6.47 mm ± 2.50 in the midline, 3.53 mm ± 2.23 on the left, and 3.81 mm ± 2.56 on the right. The length of the whole quadrangular cartilage was 25.63 mm ± 4.27; 25% ± 8% was overlapped by the nasal bone. The height of the caudal quadrangular cartilage was 18.14 mm ± 3.44, and the width of the nasal bone-upper lateral cartilage articulation was 23.56 mm ± 8.30. The upper lateral cartilage-quadrangular cartilage complex stayed in position on the maxillary crest and nasal spine, even after being dissected from the nasal bone, perpendicular plate of the ethmoid bone, and vomer. Bilateral perichondrial-periosteal mucosa detached from the nasal septum.

We report various anatomical and structural features of the Chinese keystone region, which will be valuable for rhinoseptoplasty planning in Chinese patients.