Resident Manual of Trauma to the Face, Head and Neck

CHAPTER 4: Midfacial Trauma

3. Neurovascular (Figure 4.9) y y Lateral nasal and septal arteries, from facial artery (external carotid). y y Dorsal nasal artery, from ophthalmic artery (internal carotid).

y y Sensory innervation from trigeminal nerve: •• Root and dorsum from ophthalmic (V1). •• Sidewall, mostly from maxillary (V2).

Figure 4.9 Nasal vascular anatomy.

4. Conformational y y Pyriform (“pear-shaped”) aperture: •• Bordered by nasal bones, maxilla. y y Soft tissue envelope. y y Skin externally (abundantly sebaceous) and internally, vestibule (hair-bearing “vibrissae”). y y Mucous membrane lining internal to vestibule (border is limen vestibuli ). y y Fibrofatty tissue works with cartilages and bone to maintain conformational integrity. •• Upper vault, mostly bony, is rigid. •• Lower vault, mostly cartilaginous, fibrofatty, is flexible, performs valve function. •• Paired nostrils (nares) with intervening columella containing medial crura of lower lateral cartilages. 5. Orientational Terminology (Figure 4.10) y y Dorsal: toward “bridge.” y y Cephalic: toward top of head. y y Caudal: toward mouth.

Figure 4.10 Nasal orientational terminology.

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Resident Manual of Trauma to the Face, Head, and Neck