Surgery of the Upper Respiratory System

Over the nasal bones and lateral cartilages the skin is thin and fairly freely movable. The skin is much thicker, contains more glands, and is firmly adherent over the alar cartilages. The blood supply is mainly in the soft tissues. The dissection should lie in planes of cleavage whereby vessels are avoided and bleeding is minimized. The bony nose consists of paired nasal bones which are thin in their lower half to two third, and solid in their upper third. These bones rest upon the frontal spine (nasal process) of the frontal bone and are held, as if in a vise, between the two frontal (ascending) processes of the superior maxilla. The frontal (ascending) process of the maxilla forms the lateral aspect and lower two thirds of the nose. The maxilla also forms the floor of the anterior nasal cavities.