한국 성인의 비골 및 비연골의 해부학적 고찰

Abstract

[한글]

사람의 코의 구조적인 특징에는 인종이나 지역, 유전적인 요소 이외에도 개개인에 따라 많은 변이가 있으므로 코의 구조를 어떤 범주에서 분류한다는 것은 매우 어려운 문제이다.

정상적인 코의 해부학적인 구조와 기능을 통해서 병리적 구조를 이해하는 것은 코의 수술에 있어서 필수적인 요소이다. 그러나 코의 구조에 대해서는 서로 다른 의견이 있는 것이 사실이다.

본 조사는 24구의 사체 (48편측)를 통하여 코의 구조를 이루고 있는 비골과 비연골의 크기및 모양을 성별로 분류하고 육안적 및 광학현미경적으로 관찰하여 다음과 같은 결과를 얻었다.

1. 크기에 있어서 성별로 보면 비골,비연골 모두가 남자에서 보다 큰 것을 관찰하였으며 이 차이는 비연골보다도 비골에서 더 뚜렷하였다. 크기의 변이법위(range of variation)는 비골에서는 길이, 너비모두 많은 변이범위 (range of variation)를 나타내었고, 비연골에서는 중격연골 중앙선의 거리 (표1, 3-a)에서 가장 많았고, 비익연골의 최장거리 (표1, 4-a), 외측비연골의 수직거리 (표1, 2-a)순으로 비연골에 있어서 수평폭의 거리보다는 수직거리에 있어서 보다 많은 변이 범위가 있었다.

2. 외측비연골 (lateral nasal cartilage)과 비중격연골 (septal cartilape)이 비골과 중첩 ( overlapping ) 되어지는 관계는 외측비연골이 대부분 비골에 의해서만 중첩이 될 뿐 (83.3%), 상악골 건두돌기에 의해서도 함께 중첩이 되는 것은 8예 (16.7%)에 불과 하

였다.

3. 비중격연골과 외측비연골은 서로 결합되어 있으며 비첨(apex)으로 갈수록 두 연골사이에 균열(cleft)이 점차 넓어지고 비근(roct)으로 갈수록 그 균열이 좁아지면서 섬유성 결합조직으로 대치되다가 섬유성조직이 점차 엷어지며 연골이 서로 연결되어있었다.

4. 부비연골 (accessory cartilage)의 수는 평균 0.75개 이었다.

5. 외측비연골과 비익연골 (alar cartilage)는 섬유성 결합 조직(fibro-connective tissue)으로 연결되어 있고 그 사이에 종자연골(sesamoid cartilage )이 위치하고 있었다.

ANAT0MICAL OBSERVATI0NS ON THE NASAL BONES AND CARTILAGES OF KOREAN ADULTS

In Chang Cho,

Department of Medical Science The Graduate School, Yonsei University

(Directed by Professor Jae Duk Lew, M.D.)

There are in numerable variations of the nasal structural Characteristics

according to the race, genetic factors and individuals. It it, thus, difficult to

stereotype the man's nose according to his ethnic origin, and the discriptions of

anatomy of this part in the surgical literature as well as in the standard

anatomical texts are often in disagreemmt.

Upon rhinoplasty however, visualization of the operative field is often

incomplete and successful surgery must be aware not only of the different

structures encountered, but of the precise relationship existing between these

structures.

This investigation was undertaken to help fulfill the need of the fundamental

anatomical structure of the Korean adult nose based on gross and microscopic

observations in 24 cadavoric noses (48 sides), and the results are summrized

follow.

1. The size of nasal bone and cartilage according to the sex distribution and

total.

2. Lateral and septal cartilages are known to be overlapped by the nasal bone and

frontal process of maxilla, but this investigation shows that lateral cartilage is

usually overlapped by the nasal tone only 83.3%, overlapping also the frontal

process of maxilla was only 16.7%.

3. Between lateral and septal cartilage, there is narrow cleft in caudal area and

the cleft became absent on cephalic portion and they were connected by

fibroconnective tissue, continuous with perichondrium. And on more cephalic

portion, the fibroconnective tissue reduced gradually and their continuity was

noted.

4. Number of accessory cartilage was 0.75 in average.

5. Lateral cartilage and alar cartilage are connected by loose fibroconnective

areolar tissue and sesamoid cartilages without cartilaginous continuity.

[영문]

There are in numerable variations of the nasal structural Characteristics according to the race, genetic factors and individuals. It it, thus, difficult to stereotype the man's nose according to his ethnic origin, and the discriptions of

anatomy of this part in the surgical literature as well as in the standard anatomical texts are often in disagreemmt.

Upon rhinoplasty however, visualization of the operative field is often incomplete and successful surgery must be aware not only of the different structures encountered, but of the precise relationship existing between these structures.

This investigation was undertaken to help fulfill the need of the fundamental anatomical structure of the Korean adult nose based on gross and microscopic observations in 24 cadavoric noses (48 sides), and the results are summrized follow.

1. The size of nasal bone and cartilage according to the sex distribution and total.

2. Lateral and septal cartilages are known to be overlapped by the nasal bone and frontal process of maxilla, but this investigation shows that lateral cartilage is

usually overlapped by the nasal tone only 83.3%, overlapping also the frontal process of maxilla was only 16.7%.

3. Between lateral and septal cartilage, there is narrow cleft in caudal area and the cleft became absent on cephalic portion and they were connected by fibroconnective tissue, continuous with perichondrium. And on more cephalic portion, the fibroconnective tissue reduced gradually and their continuity was

noted.

4. Number of accessory cartilage was 0.75 in average.

5. Lateral cartilage and alar cartilage are connected by loose fibroconnective areolar tissue and sesamoid cartilages without cartilaginous continuity.