Nasal Analysis

Question 1

Standard views for preop rhinoplasty

Answer 1

Frontal
Three-quarters
Lateral
Base

Question 2

Frontal View

Answer 2

Nasal length
Nasal deviation from the midline
Tip-defining points/light reflexes (5-10 mm apart)
Tip shape/contour
Brow-tip aesthetic line
"Gull in flight" configuration
Lateral crural positioning ("Parentheses deformity)
Length of upper lip

Question 3

Lateral View

Answer 3

Nasal length
Dorsal hump
Radix position
Nasofrontal angle
Tip rotation
Tip projection
Nasolabial angle
Ala/columellar relationship
Angle of divergence (double-break)
Columellar show (2-4 mm)
Chin/malar projection

Question 4

Base view

Answer 4

Columella/lobule relationship
Angle of divergence
Shape of nasal tip
Shape of nostrils
Position of caudal septum
Width of ala

Question 5

Brow-tip aesthetic line

Answer 5

Gently curved line from the medial eyebrow along the nasal dorsum to the IPSI light reflex
In a symmetric nose, should be hour-glass

Question 6

“Gull in flight” configuration

Answer 6

Silhouette from columella being slightly inferior to the alar rims

Question 7

Frankfort horizontal

Answer 7

Imaginary line from top of tragus to malar eminence

Question 8

What are the 4 aesthetic angles determined in the lateral view?

Answer 8

Nasofrontal angle
Nasofacial angle
Nasolabial angle
Nasomental angle

Question 9

Nasofrontal angle

Answer 9

Intersection of line connecting glabella and nasion and line tangent to nasal dorsum
Ideal is 115-130 deg.

Question 10

Nasolabial angle

Answer 10

Intersection of line tangent to columella and line from subnasale to upper vermillion border
Men: 90-95 deg
Women: 95-110 deg
Caudally rotated nose is often assoc w/ more acute angle (vs cephalic, obtuse)

Question 11

Nasofacial angle

Answer 11

Intersection of line tangent to nasal dorsum with line from glabella to soft tissue pogonion
Ideal: 36-40 deg

Question 12

Nasomental angle

Answer 12

Intersection of line from tip-defining point to soft tissue pogonion and a line tangent to nasal dorsum
Ideal: 120-132

Question 13

Pogonion

Answer 13

anterior midpoint of the chin

Question 14

Tip rotation

Answer 14

Determined by the angle of rotation of the dome off the Frankfort horizontal
Not equivalent to nasolabial angle, although associated

Question 15

Methods used to quantify nasal projection

Answer 15

Goode’s
Crumley’s
Simon’s

Question 16

Goode’s method to quantify nasal projection

Answer 16

A line from the alar-facial groove to the nasal tip should be 0.55-0.6 of the length of the nasal dorsum

Question 17

Crumley’s method to quantify nasal projection

Answer 17

The nasal profile is a right triangle with vertices at the nasion, alar crease, and tip-defining point
Sides should have 3:4:5 ratio with resultant nasofacial angle of 36 deg

Question 18

Simon’s method to quantify nasal projection

Answer 18

Distance from the subnasale to the upper vermilion border should equal the distance from the subnasale to the tip-defining point

Question 19

Width of the ala should equal?

Answer 19

Intercanthal distance

Question 20

Relationship of the columella and the infratip lobule is ideally?

Answer 20

2:1