The anterior nasal spine (ANS) is a sharp bony projection at the anterior and inferior aspect of the nasal aperture, formed by the united processes of the two maxillae at the lower border of the piriform aperture. It provides attachment for the lower end of the nasal septum cartilage and for the columellar base. On lateral cephalogram it is a key cephalometric point.
The anterior nasal spine is the inferior cephalometric point for measuring the anterior nasal base and for mandibular plane measurements in cephalometric analysis. In Le Fort I osteotomy, the anterior nasal spine remains attached to the mobilised maxilla or may be separately osteotomised. Nasal spine augmentation with silicone or cartilage graft improves chin-neck relationship and columellar projection in aesthetic surgery. The nasal spine is fractured in nasal bone fractures and may contribute to septal deviation.
High-impact nasal trauma fractures the anterior nasal spine, producing midline septal deviation and columellar instability; it is repaired during septorhinoplasty by reinserting the caudal septum to the remodelled nasal spine with a mattress suture through the anterior maxillary periosteum.
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