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November 1996

Vascular Anatomy of the Nose and the External Rhinoplasty Approach

Author Affiliations

Houston, Tex

Arch Otolaryngol Head Neck Surg. 1996;122(11):1276-1277. doi:10.1001/archotol.1996.01890230118023

I congratulate Toriumi et al1 for their nice study on the vascular anatomy of the nose. However, I find fault with the nomenclature used under the description of the lymphatic and nodal drainage as depicted in Figures 11 through 13. Previous studies date back to the classical treatise on the anatomy of the human lymphatic system by Henri Rouvierre.2 Figure 5 in this volume clearly describes the lymphatics of the nose distributed as external and internal lymphatics.2(p66) The external lymphatics arise from 2 papillary networks: (1) a superficial, cutaneous and (2) a deep, originating in the muscles, periosteum, and perichondrium of the region. The superficial, cutaneous network follows a superficial path or a deep path. Whichever path is followed, the collecting trunks accompany the external maxillary blood vessels (facial blood vessels) at the inferior part of the face and terminate in prevascular and retrovascular submaxillary lymph nodes.

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