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Topic

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Apex of nose

The apex of the nose refers to the most anterior and inferior projecting part of the external nose, commonly called the nasal tip. It is a soft-tissue–dominant anatomical region primarily shaped by the lower lateral (alar) cartilages and overlying skin and subcutaneous tissues.

The apex of the nose is an important surface landmark in facial anatomy, cosmetic and reconstructive surgery, trauma evaluation, and imaging assessment of the external nasal framework.

Synonyms

  • Nasal apex

  • Nasal tip

Location

  • Located at the anterior-most part of the external nose

  • Inferior to the nasal dorsum

  • Anterior to the nasal septum

  • Formed mainly by the alar cartilages

  • Superficial to the anterior nasal cavity

Anatomical components

  • Lower lateral (alar) cartilages:

    • Medial crura

    • Intermediate domes

    • Lateral crura

  • Overlying soft tissues:

    • Skin

    • Subcutaneous fat

    • Fibrofatty tissue of the nasal tip

  • Underlying structures:

    • Anterior nasal septum

    • Vestibular lining

Relations

Superficially:

  • Thick nasal skin

  • Subcutaneous fibrofatty tissue

Deep:

  • Nasal vestibule

  • Anterior septal cartilage

Medially:

  • Medial crura of alar cartilages

  • Columella

Laterally:

  • Lateral crura of alar cartilages

  • Nasal ala

Superiorly:

  • Nasal dorsum

  • Upper lateral nasal cartilages

Inferiorly:

  • Nostrils and external nasal openings

Surface anatomy

  • Tip-defining points: Determined by the domes of the lower lateral cartilages

  • Columella–lobule junction: Inferior landmark of the apex

  • Nasal lobule: Soft-tissue segment forming the bulk of the nasal tip

X-ray appearance

Plain radiographs:

  • Apex of the nose: Not directly visualized

  • Assessment: Indirect evaluation via soft-tissue outline

  • Nasal bones: Visualized posterior and superior to the apex

CT appearance

Non-contrast CT:

  • Apex: Soft-tissue density anterior to the nasal bones

  • Cartilaginous structures: Seen as non-calcified soft tissue

  • Symmetry: Evaluated by comparing bilateral alar regions

Post-contrast CT:

  • Apex soft tissues: Mild enhancement of skin and subcutaneous tissues

  • Cartilage: No enhancement

MRI appearance

T1-weighted images:

  • Nasal tip fat: High signal intensity

  • Alar cartilages: Low-to-intermediate signal

  • Skin: Intermediate signal

T2-weighted images:

  • Soft tissues: Intermediate-to-high signal

  • Cartilage: Intermediate signal

  • Nasal vestibule lining: Higher signal than cartilage

MRI images

Apex of nose axial mri

MRI images

Apex of nose mri coronal