Ultrasonographic Evaluation of Nasal Tip Anatomy for Rhinoplasty Planning

Abstract Rhinoplasty outcomes are heavily influenced by nasal tip anatomy, particularly the thickness of the soft tissue envelope (STE) and the underlying cartilaginous framework. Traditional assessment methods are subjective, prompting exploration of objective techniques such as ultrasonography. This study evaluates nasal tip anatomy using high-resolution ultrasound imaging and correlates quantitative findings with surgical implications. This prospective study enrolled 35 adult patients at a tertiary referral hospital. Patients with prior nasal surgery, injections, fractures, congenital anomalies, or significant skin disease were excluded. A 12-MHz ultrasound probe was used to measure STE thickness at the nasion, rhinion, and nasal tip, septal cartilage thickness and dorsal length, and the internal nasal valve angle (INVA). STE thickness was greatest at the nasion (4.11 ± 0.51 mm), followed by the nasal tip (3.95 ± 0.54 mm), and thinnest at the rhinion (2.49 ± 0.16 mm). The mean septal cartilage thickness was 2.09 ± 0.30 mm at the premaxilla and thinner at the dorsum (1.54 ± 0.26 mm). The mean dorsal septal length was 22.8 mm. Male patients consistently exhibited thicker STEs and septal cartilage than female patients (p < 0.001). The INVA averaged 25.7 degrees bilaterally. Ultrasonography provides a reliable, objective assessment of nasal anatomy for surgical planning. Recognition of variations in soft tissue and septal morphology facilitates tailored approaches, improving both aesthetic and functional outcomes, especially in patients with thick nasal skin.