Nasal septum

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Nasal septum
Gray854.png
Bones and cartilages of the septum of the nose. Right side.
Maxillary sinus MRI.jpg
MRI image showing nasal septum
Details
Artery Anterior ethmoidal
posterior ethmoidal
sphenopalatine
greater palatine
branch of superior labial [1]
Nerve Anterior ethmoidal
nasopalatine nerves, [1] medial posterosuperior nasal branches of pterygopalatine ganglion
Lymph Anterior half to submandibular nodes, posterior half to retropharyngeal and deep cervical lymph nodes
Identifiers
Latin septum nasi
MeSH D009300
TA98 A06.1.02.004
TA2 3137
FMA 54375
Anatomical terminology

The nasal septum (Latin : septum nasi) separates the left and right airways of the nasal cavity, dividing the two nostrils.

Contents

It is depressed by the depressor septi nasi muscle.

Structure

The fleshy external end of the nasal septum is called the columella or columella nasi, and is made up of cartilage and soft tissue. [2] The nasal septum contains bone and hyaline cartilage. [3] It is normally about 2 mm thick. [4]

The nasal septum is composed of four structures:

The lowest part of the septum is a narrow strip of bone that projects from the maxilla and the palatine bones, and is the length of the septum. This strip of bone is called the maxillary crest; it articulates in front with the septal nasal cartilage, and at the back with the vomer. [5] The maxillary crest is described in the anatomy of the nasal septum as having a maxillary component and a palatine component.

Development

Vomer of infant Gray175.png
Vomer of infant

At an early period, the septum of the nose consists of a plate of cartilage, known as the ethmovomerine cartilage.

The posterosuperior part of this cartilage is ossified to form the perpendicular plate of the ethmoid; its anteroinferior portion persists as the septal cartilage, while the vomer is ossified in the membrane covering its posteroinferior part.

Two ossification centers, one on either side of the middle line, appear about the eighth week of fetal development in this part of the membrane, and hence the vomer consists primarily of two lamellae.

About the third month, these unite below, and thus a deep groove is formed in which the cartilage is lodged.

As growth proceeds, the union of the lamellae extends upward and forward, and at the same time, the intervening plate of cartilage undergoes absorption.

By the onset of puberty the lamellae are almost completely united to form a median plate, but evidence of the bilaminar origin of the bone is seen in the everted alae of its upper border and in the groove on its anterior margin.

Clinical significance

The nasal septum can depart from the centre line of the nose in a condition that is known as a deviated septum caused by trauma. However, it is normal to have a slight deviation to one side. The septum generally stays in the midline until about the age of seven, at which point it will frequently deviate to the right. An operation to straighten the nasal septum is known as a septoplasty.

A perforated nasal septum can be caused by an ulcer, trauma due to an inserted object, long-term exposure to welding fumes, [6] or cocaine use. There is a procedure that can be of help to those suffering from the perforated septum. A silicone button can be inserted in the hole to close the open sore.

The nasal septum can be affected by both benign tumors such as fibromas, and hemangiomas, and malignant tumors such as squamous cell carcinoma.

Cosmetic procedures

A nasal septum piercing is usually carried out through the fleshy columella close to the end of the nasal septum.

Related Research Articles

<span class="mw-page-title-main">Maxilla</span> Upper jaw bone

In vertebrates, the maxilla is the upper fixed bone of the jaw formed from the fusion of two maxillary bones. In humans, the upper jaw includes the hard palate in the front of the mouth. The two maxillary bones are fused at the intermaxillary suture, forming the anterior nasal spine. This is similar to the mandible, which is also a fusion of two mandibular bones at the mandibular symphysis. The mandible is the movable part of the jaw.

<span class="mw-page-title-main">Rhinoplasty</span> Surgical procedure to enhance or reconstruct a human nose

Rhinoplasty, commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.

<span class="mw-page-title-main">Ethmoid bone</span> Bone of the facial skeleton

The ethmoid bone is an unpaired bone in the skull that separates the nasal cavity from the brain. It is located at the roof of the nose, between the two orbits. The cubical bone is lightweight due to a spongy construction. The ethmoid bone is one of the bones that make up the orbit of the eye.

<span class="mw-page-title-main">Sphenoid bone</span> Bone of the neurocranium

The sphenoid bone is an unpaired bone of the neurocranium. It is situated in the middle of the skull towards the front, in front of the basilar part of the occipital bone. The sphenoid bone is one of the seven bones that articulate to form the orbit. Its shape somewhat resembles that of a butterfly or bat with its wings extended.

<span class="mw-page-title-main">Palatine bone</span> Bone of the facial skeleton

In anatomy, the palatine bones are two irregular bones of the facial skeleton in many animal species, located above the uvula in the throat. Together with the maxilla, they comprise the hard palate.

<span class="mw-page-title-main">Inferior nasal concha</span> Facial bone

The inferior nasal concha is one of the three paired nasal conchae in the nose. It extends horizontally along the lateral wall of the nasal cavity and consists of a lamina of spongy bone, curled upon itself like a scroll,. The inferior nasal conchae are considered a pair of facial bones. As the air passes through the turbinates, the air is churned against these mucosa-lined bones in order to receive warmth, moisture and cleansing. Superior to inferior nasal concha are the middle nasal concha and superior nasal concha which both arise from the ethmoid bone, of the cranial portion of the skull. Hence, these two are considered as a part of the cranial bones.

<span class="mw-page-title-main">Vomer</span> Unpaired facial bone of the skull

The vomer is one of the unpaired facial bones of the skull. It is located in the midsagittal line, and articulates with the sphenoid, the ethmoid, the left and right palatine bones, and the left and right maxillary bones. The vomer forms the inferior part of the nasal septum in humans, with the superior part formed by the perpendicular plate of the ethmoid bone. The name is derived from the Latin word for a ploughshare and the shape of the bone.

<span class="mw-page-title-main">Nasal cavity</span> Large, air-filled space above and behind the nose in the middle of the face

The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal cavity is the uppermost part of the respiratory system and provides the nasal passage for inhaled air from the nostrils to the nasopharynx and rest of the respiratory tract.

<span class="mw-page-title-main">Septoplasty</span> Corrective surgical procedure

Septoplasty, or alternatively submucous septal resection and septal reconstruction, is a corrective surgical procedure done to straighten a deviated nasal septum – the nasal septum being the partition between the two nasal cavities. Ideally, the septum should run down the center of the nose. When it deviates into one of the cavities, it narrows that cavity and impedes airflow. Deviated nasal septum or “crooked” internal nose can occur at childbirth or as the result of an injury or other trauma. If the wall that functions as a separator of both sides of the nose is tilted towards one side at a degree greater than 50%, it might cause difficulty breathing. Often the inferior turbinate on the opposite side enlarges, which is termed compensatory hypertrophy. Deviations of the septum can lead to nasal obstruction. Most surgeries are completed in 60 minutes or less, while the recovery time could be up to several weeks. Put simply, septoplasty is a surgery that helps repair the passageways in the nose making it easier to breathe. This surgery is usually performed on patients with a deviated septum, recurrent rhinitis, or sinus issues.

<span class="mw-page-title-main">Nasal septum deviation</span> Disorder of the nose

Nasal septum deviation is a physical disorder of the nose, involving a displacement of the nasal septum. Some displacement is common, affecting 80% of people, mostly without their knowledge.

<span class="mw-page-title-main">Nasal septum perforation</span> Medical condition

A nasal septum perforation is a medical condition in which the nasal septum, the bony/cartilaginous wall dividing the nasal cavities, develops a hole or fissure.

<span class="mw-page-title-main">Kiesselbach's plexus</span> Vascular network in the nose

Kiesselbach's plexus is an anastomotic arterial network (plexus) of four or five arteries in the nose supplying the nasal septum. It lies in the anterior inferior part of the septum known as Little's area, Kiesselbach's area, or Kiesselbach's triangle. It is a common site for anterior nosebleeds.

<span class="mw-page-title-main">Perpendicular plate of ethmoid bone</span>

The perpendicular plate of the ethmoid bone is a thin, flattened lamina, polygonal in form, which descends from the under surface of the cribriform plate, and assists in forming the septum of the nose; it is generally deflected a little to one or other side. The anterior border articulates with the spine of the frontal bone and the crest of the nasal bones.

<span class="mw-page-title-main">Maxillary hiatus</span>

The maxillary hiatus is the opening of a maxillary sinus into the middle nasal meatus of the nasal cavity. It is situated superoposteriorly upon the lateral nasal wall, opening into the nasal cavity at the posterior portion of the ethmoidal infundibulum. Its opening in the maxillary sinus is present upon the superior part of the medial wall of the sinus near the roof of the sinus; because of the position, gravity cannot drain the maxillary sinus contents when the head is erect.

<span class="mw-page-title-main">Sphenopalatine foramen</span>

The sphenopalatine foramen is a foramen of the skull that connects the nasal cavity and the pterygopalatine fossa. It gives passage to the sphenopalatine artery, nasopalatine nerve, and the superior nasal nerve.

<span class="mw-page-title-main">Sphenopalatine artery</span>

The sphenopalatine artery is an artery of the head, commonly known as the artery of epistaxis. It passes through the sphenopalatine foramen to reach the nasal cavity. It is the main artery of the nasal cavity.

<span class="mw-page-title-main">Septal nasal cartilage</span> Hyaline cartilage in the nose

The septal nasal cartilage is composed of hyaline cartilage. It is somewhat quadrilateral in form, thicker at its margins than at its center, and completes the separation between the nasal cavities in front.

<span class="mw-page-title-main">Nasal cartilages</span> Supportive structures in the nose

The nasal cartilages are structures within the nose that provide form and support to the nasal cavity. The nasal cartilages are made up of a flexible material called hyaline cartilage in the distal portion of the nose. There are five individual cartilages that make up the nasal cavity: septal nasal cartilage, lateral nasal cartilage, major alar cartilage, minor alar cartilage, and vomeronasal cartilage.

<span class="mw-page-title-main">Body of sphenoid bone</span>

The body of the sphenoid bone, more or less cubical in shape, is hollowed out in its interior to form two large cavities, the sphenoidal sinuses, which are separated from each other by a septum.

<span class="mw-page-title-main">Human nose</span> Feature of the human face

The human nose is the first organ of the respiratory system. It is also the principal organ in the olfactory system. The shape of the nose is determined by the nasal bones and the nasal cartilages, including the nasal septum, which separates the nostrils and divides the nasal cavity into two.

References

  1. 1 2 lesson9 at The Anatomy Lesson by Wesley Norman (Georgetown University)
  2. Bell, Daniel J. "Columella | Radiology Reference Article | Radiopaedia.org". radiopaedia.org. Retrieved 26 October 2018.
  3. Saladin, Kenneth S. (2012). Anatomy and Physiology (6th ed.). New York, NY: McGraw Hill. p. 856. ISBN   9780073378251.
  4. Liong, Kyrin; Lee, Shu Jin; Lee, Heow Pueh (2013). "Preliminary Deformational Studies on a Finite Element Model of the Nasal Septum Reveals Key Areas for Septal Realignment and Reconstruction". Journal of Medical Engineering. 2013: 1–8. doi: 10.1155/2013/250274 . ISSN   2314-5129. PMC   4782633 . PMID   27006910.
  5. Sedaghat, A. "Septoplasty for deviation of the nasal septum" (PDF).
  6. Lee, Choong Ryeol; Yoo, Cheol In; Lee, Ji Ho; Kang, Seong Kyu (2002). "Nasal Septum Perforation of Welders". Journal of Industrial Health. 40 (3): 286–289. doi: 10.2486/indhealth.40.286 . PMID   12141379.