Three-dimensional computerized anthropometry of the nose

The quantitative assessment of the dimensions of facial soft-tissue structures, their relative proportions, and reciprocal spatial positions is an essential component of the clinical analysis of patients seeking maxillo-facial treatments. In particular, nasal morphology and dimensions play a key role in facial harmony, and modifications of nasal characteristics are among those most asked by patients worldwide. Currently, cosmetic rhinoplasty is the fourth most common surgical procedure in the USA. For a quantitative description of human noses, various methods have been used, both in two (photographs) and three dimensions (direct facial anthropometry, measurements on stone casts, and indirect anthropometry on digital reproductions). Additionally, intrauterine assessments for the prenatal diagnosis of chromosomal alterations and cleft lip are being made by ultrasonography. In healthy persons, data were reported for nasal linear measurements, angles, external area and volume, nostril dimensions, angles, and symmetry. In both sexes, the fastest child and adolescent growth was found for vertical distances, which doubled their values from birth to young adulthood. Male values were always larger than female values. A large increment was also observed for the antero-posterior distances, with limited sexual dimorphism. The largest sexual dimorphism (males larger than females), and the smallest age-related increments, were found for nasal horizontal measurements. Normal growth and development of the nose did not stop in early adulthood. The cartilaginous tissues of the face continue to grow during maturity and old age, giving older people longer and larger noses. The largest ethnic variations in the nose were found in the descriptors of nasal shape, that is, the angles. During growth, nasal volume progressively increased from childhood to young adulthood, but its modifications continued even after the attainment of skeletal maturity. At 3–4 years of age, nasal volume was approximately 36% (boys) and 42%(girls) of the mean value attained in young adulthood. In old adults, nasal volume was 120% (men) and 118% (women) of the mean value of the 18–30 age group. Nasal size and shape in the different ages and ethnic groups may be usefully employed for clinical assessments, surgical interventions, and forensic reconstructions.