Regional Variability in Compressive Strength of the Cartilaginous Nasal Septum: Implications for Fracture Patterns

Septal trauma is caused by compressive forces. Defining regional variability in compressive strength (CS) may reveal areas of weakness in the septum that are more prone to fracture. The objective of this study is to determine the CS at multiple locations within the cartilaginous septum and assess if variations in strength correlate with known patterns of septal fracture.

Nineteen nasal septal quadrangular cartilages were dissected from fresh human anatomic specimens. Septa were divided into 11 sections using known anatomical and relative points. Each septum was cut into multiple 5 mm × 5 mm boxes, and the CS was measured using a force gauge.

The CS of the anterior septal point (ASP) was 0.072 MPa, keystone area 0.132 MPa, anterior nasal spine (ANS) 0.182 MPa, and posterior septal point (PSP) 0.204 MPa. The highest mean CS was located at the PSP (0.204 MPa). The lowest value was located at the ASP (0.072 MPa). The greatest regional difference in CS was found at the transition between the caudal L-strut and the ASP (0.09 MPa; 63%), the transition between the posterior caudal septum and the PSP (0.07 MPa, 42%), and the transition between mid-septal body and the ANS (0.06 MPa, 39%).

There is high regional variability in CS at multiple locations within the cartilaginous septum. Septal fractures often occur between areas where there is a high regional difference in CS. This data may help inform choice of optimal donor and recipient site when considering grafting of the nasal septum.

NA. Laryngoscope, 135:2353-2358, 2025.