Optimizing bone-graft nasal reconstruction: a study of nasal bone shape and thickness

Nasal reconstruction may best be carried out with bone grafting in certain cases of loss of structural support. In order to optimize both the aesthetic and functional results of bone-graft nasal reconstruction, we studied the shape and thickness of the normal human nasal bone. Sixty Caucasian skull nasal bones were measured by width throughout their length at three planes of depth. Seventeen Caucasian cadaver nasal bones were examined to determine the thickness of the bone throughout its length at three sagittal planes. The results showed that the nasal bone was widest at the nasofrontal suture (14 mm), narrowest at the nasofrontal angle (10 mm), and then widened again to a maximum width of 12 mm about 9 to 12 mm inferior to the nasofrontal angle. The nasal bone was thickest superiorly at the nasofrontal angle (average 6 mm) and progressively thinned toward the tip. It was 3 to 4 mm thick in the critical area where screws are most commonly placed for fixation (5 to 10 mm inferior to the nasofrontal angle). From these data, three-dimensional models of the normal nasal bone shape were formulated and used in clinical bone-graft cases.