Figure 9: Tension-system of the nasal base, maintained by septal cartilage
a-c: Regular situation
a) Lateral view: The septo-dorsal-cartilage (2) forms the cartilaginous dorsum and projects beyond the level of the anterior nasal spine for some millimeters. This projects the columella-base more caudal in relation to the nostrils and creates a physiologic nasolabial angle (3). The domes are above the level of the anterior inferior corner of the septal cartilage (1).
b) Base view: Soft tissue connects the domes (4) and rests on the upper septal corner.
c) Tension of the alar cartilages results in oval shaped nostrils (6), narrow nasal base (7) and tip (8).
d-f: Consequences of loss of tension caused by septal pathology
d) Lateral view: Reduction of septal height (9) results in a cartilaginous saddle (10), drooping tip (11) and retracted columella base (12).
e) Base view: Loss of septal height by cartilage defects, twisting or dislocation (9) as well as disruption of the interdomal connective tissue (14). The dome angles become more round.
f) Consequences for the soft-tissue envelope: Wide columella-base (16), round nostrils (15) and amorphous tip (17)