Nasal Anatomy: Questions About Nasal Cartilage Asymmetry

Q: Nasal Anatomy: Questions About Nasal Cartilage Asymmetry

Hello, regarding the above questions： Q1, Q2 -> Asymmetry in the nasal structure is quite common and is not limited to cartilage. <br>Q3 -> If it is indeed diagnosed as a simple visible external nasal valve collapse, the relationship with the medial crura of the lower lateral car

Questions about the nose?

Dear Dr.
Chi,
I noticed in your specialty introduction that you have expertise in "nasal reshaping and correction," so I would like to seek your clarification.
In my left nasal cavity, there is a slightly protruding area in the anterior segment, and there is a similar structure in the right nasal cavity, but the protrusion in the left nasal cavity feels more pronounced than that in the right.
Upon researching relevant medical information, I found that the protrusions in both nasal cavities are likely the medial crura of the lower lateral cartilages (which I believe are referred to as the footplates of the medial crura in English), resembling two pieces of cartilage shaped like )( that can be palpated in the anterior segment of both nasal cavities.

I have the following questions for you, Dr.
Chi:
Q1.
Based on my research, I understand that these two pieces of cartilage should generally be symmetrical and of equal size.
Could you explain why the medial crura of the lower lateral cartilage in my left nasal cavity feels more pronounced than that in my right nasal cavity? Additionally, what are the common causes of such a condition? (For example, could it be due to a deviated septum causing asymmetry in the cartilage, or could it be that the left and right cartilages are inherently different in size or orientation, or are there other factors involved?)
Q2.
In your clinical experience (or to your knowledge), how common is it for individuals to have asymmetry in the medial crura of the lower lateral cartilages? Is it more common or less common? Or is it the case that asymmetry in the medial crura is the norm, as most people have varying degrees of septal deviation, making perfectly symmetrical medial crura relatively rare?
Q3.
When I inhale forcefully through my left nostril, I experience a phenomenon known as "external nasal valve collapse." Could the pronounced medial crura of the lower lateral cartilage in my left nasal cavity be the cause of this collapse when I inhale forcefully, or are the two issues unrelated?
Q4.
Currently, aside from the "external nasal valve collapse" when I inhale forcefully through my left nostril, I do not experience any other discomfort (such as hypoxia, rhinitis, or nasal congestion); I only feel the more pronounced cartilage in the anterior segment of my left nasal cavity, while I cannot palpate that cartilage in my right nasal cavity.
In your opinion, do I need to undergo surgery to correct or remove the more prominent cartilage in my left nasal cavity? Furthermore, would such surgery pose any risks or potential complications for my nasal cavity?
Thank you, Dr.
Chi.

Axiang, 40~49 year old female. Ask Date: 2022/10/14

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding the above questions: Q1, Q2 -> Asymmetry in the nasal structure is quite common and is not limited to cartilage.
Q3 -> If it is indeed diagnosed as a simple visible external nasal valve collapse, the relationship with the medial crura of the lower lateral cartilage is usually weak.
Q4 -> If there are no functional or aesthetic concerns, surgery may not be necessary.
If there are worries about underlying issues that are not visible, it is recommended to consult an otolaryngologist.
Wishing you peace and good health.

Reply Date: 2022/10/14

More Info

Understanding nasal anatomy, particularly the asymmetry of nasal cartilage, is crucial for addressing various nasal issues, including breathing difficulties and aesthetic concerns. Your questions about the medial crura of the lower lateral nasal cartilage provide an excellent opportunity to delve into this topic.

Q1: Why is the medial crura of the lower lateral cartilage on the left side more prominent than on the right? What could cause this asymmetry?
Nasal asymmetry is relatively common and can arise from several factors. The medial crura of the lower lateral cartilage, which are responsible for the shape and support of the nasal tip, can exhibit variations in size and prominence due to genetic factors, developmental anomalies, or trauma. In your case, the more pronounced left medial crura could be a result of a congenital difference, where the cartilage developed asymmetrically. Additionally, a deviated nasal septum can influence the surrounding structures, leading to compensatory changes in the cartilage. Other factors, such as previous injuries or surgical interventions, can also contribute to this asymmetry.

Q2: Is it common for individuals to have asymmetrical medial crura?
Asymmetry in the nasal cartilages, including the medial crura, is not uncommon. Many individuals have some degree of nasal asymmetry, which can be exacerbated by a deviated septum, as you mentioned. While perfectly symmetrical nasal structures are ideal, they are relatively rare. Most people exhibit some degree of variation, whether due to natural growth patterns or external influences. Therefore, it is reasonable to conclude that asymmetry in the medial crura is a common occurrence.

Q3: Could the prominence of the left medial crura be causing the external nasal valve collapse during inhalation?
The external nasal valve is the area where the lower lateral cartilages meet the nasal septum, and its function is crucial for maintaining airflow during breathing. If the left medial crura is more prominent, it could potentially contribute to the collapse of the external nasal valve, especially during forceful inhalation. This collapse can occur if the surrounding structures do not provide adequate support. However, it is essential to consider that other factors, such as the overall shape of the nose, the condition of the nasal septum, and the presence of any swelling or inflammation, can also play significant roles in this phenomenon.

Q4: Should I consider surgery to correct the prominent left medial crura, and what are the risks?
Surgical intervention to correct nasal asymmetry or address functional issues should be carefully considered. If the prominence of the left medial crura is causing significant functional problems, such as external valve collapse leading to breathing difficulties, surgery may be warranted. However, if you are not experiencing significant discomfort or functional impairment beyond the collapse during inhalation, it may be advisable to monitor the situation rather than pursue surgery.

Surgical procedures, such as rhinoplasty, can effectively correct asymmetries and improve nasal function. However, they carry risks, including infection, scarring, and potential changes in nasal function. It is crucial to consult with a qualified ENT specialist or a plastic surgeon specializing in nasal surgery to discuss your specific case, evaluate the potential benefits and risks, and determine the best course of action.

In summary, nasal asymmetry, particularly in the medial crura, is a common occurrence and can arise from various factors. While it may contribute to functional issues like external valve collapse, the decision to pursue surgical correction should be based on a thorough evaluation of your symptoms and the potential risks involved. Consulting with a specialist will provide you with the best guidance tailored to your individual needs.

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