“COMPARATIVE STUDY OF VARIOUS NASAL PARAMETERS AMONG NORTHERN AND SOUTHERN POPULATION OF INDIA”.

Abstract

Background: The shape of the nose is a signature indicating the ethnicity ,race, age, and sex. Anthropometric parameters vary with age, sex, and ethnic background, and several authors have attempted to document normative values which may serve as references. Materials and Methods: This study includes measurement of different parameters of nose among 14 North Indian(9 males;5 females) and 61 South Indian medical students (27 males;34 females) using vernier calliper and was statistically analysed. Results: The means of various parameters were- 1)Nasal Breadth -2.8cm (North Indians) and 2.7 cm(South Indians).2)Nasal height5.2cm(North Indians) and 4.9cm(South Indians).3)The nasofacial angle-39.4 degree(North Indians) and 37.2 degree(South Indians).4)The nasolabial angle is 118.2 degree(North Indians) and 115.9 degree(South Indians).5)The nasofrontal angle 129.3 degree(North Indians) and 131.3degree(South Indians).6).The most common type of nose is leptorrhine in both North and South Indians. Conclusion: All the measurements can be used for evaluation of nasal deformity, treatment planning and post surgical evaluation of the correction achieved during rhinoplasty.

Full text

“COMPARATIVE STUDY OF VARIOUS NASAL PARAMETERS AMONG NORTHERN AND SOUTHERN POPULATION OF INDIA”.
Dr.Mukherjee Ankita Atin*
DNB ENT and HNS,DLO;Senior Resident,Department of ENT and HNS,College of Medicine and JNM Hospital,Kalyani,West Bengal,India. *Corresponding Author
Original Research PaperOtorhinolaryngologyINTRODUCTIONA good facial aesthetics inuences the judgement of culture-specic beauty as it expresses the tastes and values of that society.It also plays an important role in the assessment of personality and social acceptance. The surgeon must be sensitive to the values expressed by the patients and should integrate their desires to emulate these cultural values.Thus, a common aesthetic sense prevails that serves as a base for aesthetic judgements of taste . Indian population is a blend of Negrito Mongoloid, Caucasoid, and Australoid races that reects diversied culture, language, ethnic and genetic background but there is a clear demarcation in genetic and physical components between 1North and South Indian populations. For rhinoplasty,studying these variations of nose will give idea about the anthropometric aspects of nose northern and southern population. The face is divided into three 2equal portions by four horizontal lines. From above downwards, trichion at the hairline in the middle of the forehead,the nasion at the frontonasal suture at the level of eyebrows,the subnasal at the depth of nasolabial angle and gnathion at the lowermost point on the front of 2nose. ŸGlabella-Bony triangular area on frontal bone between the 2supraorbital ridges.ŸNasion-Junction of upper end of suture between nasal bones with 2frontal bones. 2ŸRhinion-The lower end of suture between the nasal bones. ŸSubnasal-Point at the nasal spine where the nasal septum merges 2with upper lip in the mid saggital plane. 2ŸFrankfort line-A line along intraorbital border and tragus.2ŸGnathion-Lowest point in the midline of chin.MATERIALS AND METHODSClearance from the Institutional ethics committee and consent were obtained from 61 South Indian(males-27;females-34) and 14 North Indian(males-9;females-5) medical students aged between 21 and 25 years,procedure was explained to them. Pictures of basal view,frontal view,prole view of nose of the students were taken methodically by single observer to prevent inter-observer error. Measurements using Vernier calipers were taken and statistically analysed. Students who have undergone previous rhinoplasty or nasal surgeries or having any diseases of the nose which are causing destruction or deformities of the nose or having obvious history of trauma or injury to nose were not included in the study.The photographic set up consisted of Canon SX610 HS Digital camera with camera effective pixels of approx 20.2 megapixels.Aspect ratio 4:3.Focal length of lens:18x zoom:4.5(w)-81.0(T) mm,35 mm lm equivalent 25(W)-450(T)mm.All images are taken under uniform illumination.The subjects were asked to sit against a dark coloured backdrop and were asked to look straight into the camera in natural head position with facial muscles relaxed.Photographs were taken according to each view.The photographs were analysed using Digimiser Software.All the photographs were taken at a distance of 5 feet for a sharp image.Analysis was done using student's t test .The parameters measured were-31. Nasal Breadth- The maximum distance between two ala.2. Nasal height- Height of the nose (NH) from nasion (midpoint of nasofrontal suture) to subnasale (junction between lower border 3of the nasal septum and the cutaneous portion of the upper lip).3. Nasofacial angle-The angle between a line touching the nasion and chin and the dorsal plane of the nose.It is between 30 degree 2and 40 degree.4. Nasolabial angle-The angle between columella and plane of the upper lip with its apex at subnasal.It is between 90 -95 degree for 2males and 100-110 degree for females.5. Nasofrontal angle-The angle between dorsum of nose and 2glabellar part of the forehead.It is about 125 degree.Nasal Index which is Nasal Breadth/ Nasal Height x100 was calculated and types of nose was classied into Leptorrhine,Mesorrhine and platyrrhine. Leptorrhine has Nasal index of 69.90 or less, Mesorrhine has Nasal index between 70 & 84.90 and Platyrrhine has nasal index of 385 & above.RESULTSThe mean values of different nasal parameters are enlisted below:1.Nasal breadth- a)Among North Indians,the mean nasal breadth was 2.8cm and it varied from 2.41 cm to 3.19 cm. Out of 14 ,8(57.14%) lie the range,4(28.57%) more than the range and 2(14.28%) less than the range . b)The mean nasal breadth among South Indians was 2.7 cm and it varied from 2.33 cm to 3.07 cm. Out of 61 ,47(77.05%) lie within the range,10(16.39%) more than the range and 4(6.55%) less than the range . 2.Nasal Height- a)Among North Indians,the mean nasal height was 5.2cm and it varied from 4.31 cm to 6.09 cm. Out of 14 ,13(92.86%) lie the range,1(7.14%) more than the range and nobody less than the range . b)The mean nasal height among South Indians was 4.9 cm and it varied from 4.57 cm to 5.23cm. Out of 61 ,40(65.57%) lie within the range,13(21.31%) more than the range and 8(13.11%) less than the range . Background: The shape of the nose is a signature indicating the ethnicity ,race, age, and sex. Anthropometric parameters vary with age, sex, and ethnic background, and several authors have attempted to document normative values which may serve as references.Materials and Methods: This study includes measurement of different parameters of nose among 14 North Indian(9 males;5 females) and 61 South Indian medical students (27 males;34 females) using vernier calliper and was statistically analysed.Results: The means of various parameters were- 1)Nasal Breadth -2.8cm (North Indians) and 2.7 cm(South Indians).2)Nasal height-5.2cm(North Indians) and 4.9cm(South Indians).3)The nasofacial angle-39.4 degree(North Indians) and 37.2 degree(South Indians).4)The nasolabial angle is 118.2 degree(North Indians) and 115.9 degree(South Indians).5)The nasofrontal angle 129.3 degree(North Indians) and 131.3degree(South Indians).6).The most common type of nose is leptorrhine in both North and South Indians.Conclusion: All the measurements can be used for evaluation of nasal deformity, treatment planning and post surgical evaluation of the correction achieved during rhinoplasty.ABSTRACT
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Volume - 11 | Issue - 06 | June - 2021 | . PRINT ISSN No2249 - 555X | DOI : 10.36106/ijar
KEYWORDS : Leptorrhine,nasal height,nasofrontal angle,mesorrhine
Dr.Shivaam Kesarwaani
MS ENT and HNS;Senior Resident,Department of ENT and HNS,Calcutta National Medical College,Kolkata, West Bengal,India.

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3.Nasofacial angle- a)Among North Indians,the mean nasofacial angle was 39.4 degree and it varied from 35.22 to 43.58 degree. Out of 14 ,10(71.43%) lie the range,1(7.14%) more than the range and 4(28.57%) less than the range . b)The mean nasofacial angle among South Indians was 37.2 degree and it varied from 33.09 to 41.31degree. Out of 61 ,44(72.13%) lie within the range,10(16.39%) more than the range and 7(11.47%) less than the range .4. Nasolabial angle- a)Among North Indians,the mean nasolabial angle was 118.2degree and it varied from 110.48 to 125.92 degree. Out of 14 ,10(71.43%) lie the range,2(14.28%) more than the range and 2(14.28%) less than the range . b)The mean nasolabial angle among South Indians was 115.9 degree and it varied from 108.2 to 123.6 degree. Out of 61 ,44(72.13%) lie within the range,7(11.47%) more than the range and 10(16.39%) less than the range .5. Nasofrontal angle- a)Among North Indians,the mean nasofrontal angle was 129.3degree and it varied from 121.38 to 137.22 degree. Out of 14 ,8(57.14%) lie the range,4(28.57%) more than the range and 2(14.28%) less than the range . b)The mean nasofrontal angle among South Indians was 131.3.7 degree and it varied from 121.81 to 140.79 degree. Out of 61 ,44(72.13%) lie within the range,10(16.39%) more than the range and 7(11.47%) less than the range .6.Type of nose-The most common type of nose was found to be leptorrhine followed by mesorrhine and platyrrhine in both North and South Indians.In North Indians, out of 14, 13(92.86%) have leptorrhine type,1(7.14%) have mesorrhine type and no one had platyrrhine type.In South Indians, out of 61,50(81.97%) have leptorrhine type,10(16.39%) have mesorrhine type and 1(1.64%) platyrrhine type .DISCUSSIONThe nasal pyramid plays a noticeable cosmetic role in the appearance of the whole face; it provides harmony and balance to the face.The shape of the nose is a signature indicating the ethnicity,race, age, and sex.Anthropometric parameters vary with age, sex, and ethnic background, and several authors have attempted to document 4normative values which may serve as references. This study is aimed to describe the differences in various nasal anthropometric measurements among North Indian and South Indian population.The mean nasal breadth for North Indians was found to be 2.8±0.39 cm which is more than South Indians( 2.7±0.37cm). The mean nasal height for North Indians was 5.2±0.89cm which is again higher than South Indians(4.9±0.33 cm). The mean nasal breadth and nasal height 56were lower than that found by Patil et al ,Jagadish Chandra et al and 78 Khanderkar et al. but higher than what reported by Sudhakar et al. The mean Nasofacial angle in North Indians was 39.4±4.18 degree that was greater than South Indians (37.2 ±4.11degree).According to 9Naini et al , the ideal nasofacial angle was 30 degree with range from 27 to 36 degree;above which it was considered unattractive.The mean Nasolabial angle in North Indians was 118.2 ±7.72degree that was greater than South Indians(115.9±7.70degree) .This result is 10greater than what was advised by Vinay Dua et al in Indian 11population ,Ahmet Uzhun et al in Turkish population and by Jay P 12Fitzgerald et al in white population in US.The mean Nasofrontal angle in North Indians was 129.3±7.92 degree that was lesser than South Indians(131.3±9.49 degree).This result is 13lesser than that found by Munish Reddy et al and Ahmet Uzun et al 12in Turkish population.In the present study,North Indians have leptorrhine followed by mesorrhine and no platyrrhine type of nose.South Indians have leptorrhine followed by mesorrhine and one platyrrhine This was 3similar to study by Radha et al and opposite to the ndings of Patil et 5 al who stated that the common type of nose in South Indian populationwas Mesorrhine in males and leptorrhine in females and also that of 1415Kannan et al and Gangrade et al who found the predominant type was mesorrhine pattern in North Indian population.SummaryThe shape of the nose is a signature indicating the ethnicity ,race, age, and sex. Anthropometric parameters vary with age, sex, and ethnic background, and several authors have attempted to document normative values which may serve as references.This study includes measurement of different parameters of nose among 14 North Indian(9 males;5 females) and 61 South Indian medical students (27 males;34 females) using vernier calliper and was statistically analysed.The means of various parameters were- 1)Nasal Breadth -2.8cm (North Indians) and 2.7 cm(South Indians).2)Nasal height-5.2cm(North Indians) and 4.9cm(South Indians).3)The nasofacial angle-39.4 degree(North Indians) and 37.2 degree(South Indians). 4)The nasolabial angle is 118.2 degree(North Indians) and 115.9 degree(South Indians).5)The nasofrontal angle 129.3 degree(North Indians) and 131.3degree(South Indians).6).The most common type of nose is leptorrhine in both North and South Indians.All the measurements can be used for evaluation of nasal deformity, treatment planning and post surgical evaluation of the correction achieved during rhinoplasty.Table 1: Mean with standard deviation of different nasal parameters in North IndiansTable 2: Mean with standard deviation of different nasal parameters in South IndiansTable 3: Frequency of types of nose in North and South Indians Figure 1.Nasofacial angleCONCLUSIONThe difference in the anthropometric measurements between North and South Indians is due to geographical and regional variations because of difference in ethnicity and genetic composition. Thus, this study can be used as a reference for evaluation of nasal deformity, treatment planning and post surgical evaluation of the correction achieved during rhinoplasty.REFERENCES1. Majumder PP. People of India: biological diversity and afnities. Evolut Anthro. 6: 100-110. (1998).2. V.P Sood .Corrective rhinoplasty.3rd edition.2013:17-18,28-29.3. Radha K,Srinivasan KR. Nasal index: A cross sectional study among South Indian po pul atio n.I ndia n Jo urn al o f C lini cal Anat omy and Phys iol ogy. Apri l-June.2019;6(2):201-204.4. Heidari Z, Mahmoudzadeh-Sagheb H, Khammar T, Khammar M. Anthropometric measurements of external nose in 18-25- year-old Sistani and Baluch aborigine women
Volume - 11 | Issue - 06 | June - 2021 | . PRINT ISSN No2249 - 555X | DOI : 10.36106/ijar
Nasal Parameters
Mean
Standard deviation
Minimum
Maximum
Nasal breadth (cm)
2.8
0.39
2.41
3.19
Nasal height(cm)
5.2
0.89
4.31
6.09
Nasofacial angle(degree)
39.4
4.18
35.22
43.58
Nasolabial angle(degree)
118.2
7.72
110.48
125.92
Nasofrontal angle(degree)
129.3
7.92
121.38
137.22
Nasal Parameters
Mean
Standard deviation
Minimum
Maximum
Nasal breadth (cm)
2.7
0.37
2.33
3.07
Nasal height(cm)
4.9
0.33
4.57
5.23
Nasofacial angle(degree)
37.2
4.11
33.09
41.31
Nasolabial angle(degree)
115.9
7.70
108.2
123.6
Nasofrontal angle(degree)
131.3
9.49
121.81
140.79
Gender
Leptorrhine
Mesorrhine
Platyrrhine
North Indians
13(92.86%)
1(7.14%)
0
South Indians
50(81.97%)
10(16.39%)
1(1.64%)

in the southeast of Iran. Folia Morphol 2009;68(2):88-92.5. Patil GV, Shishir kumar, Apoorva D, Thejeshwari. Study of nasal index in South Indian population. Int J Curr Res 2014:6(8);8163-4.6. Jagadish Chandra H, Ravi MS, Sharma SM, Rajendra Prasad B. Standards of facial aesthetics: An anthropometric study. J Maxillofac Oral Surg 2012;11(4):384-9.7. Khanderkar B, Srinivasan S, Mokal N. Anthropometric analysis of lip-nose complex in Indian population. Indian J Plat Surg 2005;8:128-31.8. Ray SK, Saha K, Kumar A, Banjare S. Anthropometric Study of Nasal Index among the Population of Western Uttar Pradesh Region. Int J Sci Stud 2016;4(2):65-70.9. F arhad B.Naini,Mar tyn T.Cobourne,Umberto Garagiola,Frase r McDonald,David Wertheim.Nasofacial angle and nasal prominence:A quantitative investigation of idealized aand normative values.Journal of Cranio-Maxillo-Facial Surgery 44(2016) 446-452.10. Dua V,Gupta S,Singh C.Evaluation of nasolabial angle in the Indian Population. Contemp Clin Dent. 2010;1:79-82.11. Ahmet Uzun,Fikri Ozdemir.Morphpmetric analysis of nasal shapes and angles in young adults.Braz J Otorhinolaryngol.2014;80:397-402.12. Jay Fitzgerald.An evaluation of the nasolabial angle and the relative inclinations of the nose and upper lip.Am J Orthod Dentofacial Orthop.1992;102:328-334.13. Reddy M,Ahuja NK, Raghav P, Kundu V,Mishra V.A computer-assisted Angular Photogrammetric Analysis of the soft tissue facial prole of North Indian Adults.J Ind Orthod Soc.2011;45(3):119-123.14. Kannan UG, Achleshwar G, Apurva D. Morphometric variation in nose types of Gujarati population. Asian J Med Res 2012:1:118-20.15. Gangrade PR, Babel H. Anthropometric study of the nasal index of Bhil-Meena tribe of Southern Rajasthan. Int J Curr Rev 2012:4;88-91.
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Volume - 11 | Issue - 06 | June - 2021 | . PRINT ISSN No2249 - 555X | DOI : 10.36106/ijar