Anatomical Relationship of Lateral Low-to-Low Nasal Osteotomy and Inferior Nasal Turbinate. Is Webster’s Triangle Still Important?
Issued Date
2026-05-01
Resource Type
ISSN
22346163
eISSN
22346171
Scopus ID
2-s2.0-105040650997
Journal Title
Archives of Plastic Surgery
Volume
53
Issue
3
Start Page
227
End Page
233
Rights Holder(s)
SCOPUS
Bibliographic Citation
Archives of Plastic Surgery Vol.53 No.3 (2026) , 227-233
Suggested Citation
Setthajindalert A., Tunlayadechanont P., Tantitham T. Anatomical Relationship of Lateral Low-to-Low Nasal Osteotomy and Inferior Nasal Turbinate. Is Webster’s Triangle Still Important?. Archives of Plastic Surgery Vol.53 No.3 (2026) , 227-233. 233. doi:10.1055/a-2836-2147 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117221
Title
Anatomical Relationship of Lateral Low-to-Low Nasal Osteotomy and Inferior Nasal Turbinate. Is Webster’s Triangle Still Important?
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Abstract
Background Lateral low-to-low osteotomies in rhinoplasty raise safety concerns regarding Webster’s triangle and airway patency. This study aimed to measure the distance between the osteotomy line and the anterior inferior nasal turbinate and evaluate its relationship with other nasal characteristics. Methods We retrospectively analyzed CT scans from 81 East Asian patients (January–December 2020). This study used a virtual simulation to measure the distance between a projected lateral low-to-low osteotomy line and the anterior inferior nasal turbinate on CT scans, along with nasal bone length/thickness, pyriform aperture width, and rhinion–nasomaxillary suture distance. Linear regression and Spearman correlation assessed parameter associations. Results The 81 patients (mean age 46.7 years) showed an average distance of 7.1 + 3.2 mm (right) and 6.5 + 3.0 mm (left) between the osteotomy line and the inferior nasal turbinate. A significant negative correlation (r = -0.35, p < 0.001) was found between rhinion–nasomaxillary suture distance and this osteotomy–turbinate distance. No correlation was seen with nasal bone length or pyriform aperture width. Measurements demonstrated good intrarater reliability (intraclass correlation coefficient [ICC] = 0.98). Conclusions The lateral low-to-low osteotomy line does not intersect the anterior nasal turbinate, indicating it can be safely performed without concern for Webster’s triangle. However, caution is advised for patients with higher nasal dorsum projection (shorter rhinion–nasomaxillary suture distance). This study offers valuable insights into East Asian nasal characteristics for rhinoplasty.