Dorsal nasal artery

The dorsal nasal artery is a terminal branch of the ophthalmic artery, which supplies blood to the upper part of the nose, including the nasal bridge, and the surrounding tissues. It is a key vessel that contributes to the vascular supply of the nasal region, especially the soft tissues and skin around the nose.

Location

The dorsal nasal artery originates from the ophthalmic artery as it exits the orbit. It emerges medially, passing above the medial canthus (the corner where the eyelids meet). The artery travels downward along the nasal bridge, providing blood to the surrounding skin and soft tissues. It runs close to the nasal bone and forms anastomoses with branches of the facial artery, such as the lateral nasal artery, ensuring an extensive blood supply to the upper nose and adjacent areas.

Anatomy

The dorsal nasal artery is a terminal branch of the ophthalmic artery that plays an important role in supplying blood to the upper part of the nose, particularly the nasal bridge and surrounding soft tissues. Its course and branching patterns are essential for understanding its vascular contributions to the nose and facial region. Below is a detailed description of the anatomy of the dorsal nasal artery.

Origin

The dorsal nasal artery originates from the ophthalmic artery, which itself is a branch of the internal carotid artery. It arises as one of the terminal branches of the ophthalmic artery as it exits the orbit, usually near the medial canthus (the corner of the eye where the upper and lower eyelids meet). The ophthalmic artery passes through the optic canal into the orbit, where it gives off several branches, including the dorsal nasal artery as one of its final branches.

Course

Intraorbital Segment:

After originating from the ophthalmic artery within the orbit, the dorsal nasal artery travels medially toward the nasal region. It runs along the superior margin of the orbit, passing close to the medial palpebral ligament and the trochlea (a structure through which the tendon of the superior oblique muscle passes).

Exit from the Orbit:

The artery exits the orbit through the medial canthus area, specifically near the lacrimal sac. As it passes out of the orbit, it runs superior to the medial palpebral ligament, emerging between the orbit and the nasal bridge.

Descent Along the Nasal Bridge:

Once the artery exits the orbit, it descends along the nasal bridge. It runs on the superior part of the nasal bone, supplying blood to the skin and soft tissues in this region. The dorsal nasal artery is closely related to the nasal bone and the surrounding connective tissues, making it a key vessel for the upper nose.

Anastomosis with the Facial Artery:

• As the dorsal nasal artery descends along the nasal bridge, it forms an important anastomosis with branches of the facial artery, particularly the lateral nasal artery. This connection ensures a robust blood supply to the nose by creating collateral circulation between the ophthalmic and facial arterial systems.
• The anastomoses between the dorsal nasal artery and facial artery branches ensure that blood can still reach the nasal region even if one arterial source is compromised.

Branches

• Branches to the Nasal Bridge: The dorsal nasal artery gives off small branches that supply the skin and soft tissues of the nasal bridge. These branches provide oxygenated blood to the overlying skin, connective tissues, and superficial layers of the nose.
• Branches to the Lacrimal Sac: During its course near the medial canthus, the dorsal nasal artery gives off small branches that supply the lacrimal sac, an important structure involved in tear drainage. These branches ensure that the lacrimal sac remains well-vascularized and functional.
• Anastomotic Branches: The dorsal nasal artery’s most significant branches are its anastomotic branches that connect with the lateral nasal artery and other branches of the facial artery. These anastomoses create a rich vascular network, ensuring that the upper nose and adjacent facial regions receive sufficient blood flow from multiple arterial sources.

Anatomical Relations

• Medial Canthus: The dorsal nasal artery passes close to the medial canthus, the area where the upper and lower eyelids meet. This region is also where the lacrimal sac and medial palpebral ligament are located. The artery runs superior to these structures before descending toward the nasal bridge.
• Trochlea and Superior Oblique Muscle: Near its origin, the dorsal nasal artery passes close to the trochlea, the fibrous loop that the tendon of the superior oblique muscle passes through. The artery is located near this structure as it exits the orbit, but it does not supply the superior oblique muscle directly.
• Nasal Bone: As the artery descends along the nasal bridge, it runs close to the nasal bone, supplying the overlying skin and soft tissues. The nasal bone forms the bony structure of the upper nose, and the dorsal nasal artery provides critical vascularization to this area.
• Lacrimal Sac: The dorsal nasal artery gives small branches to the lacrimal sac, which lies just inferior to the medial canthus. The lacrimal sac is responsible for collecting tears from the eye before draining them into the nasolacrimal duct. The artery ensures that this structure receives an adequate blood supply.

Anastomoses

• Anastomosis with Lateral Nasal Artery: The dorsal nasal artery forms an important anastomosis with the lateral nasal artery, a branch of the facial artery. This connection ensures that the nasal region has a dual blood supply from both the ophthalmic and facial arterial systems. This redundancy is important in maintaining blood flow even in cases of arterial injury or blockage.
• Anastomosis with Angular Artery: The dorsal nasal artery may also anastomose with the angular artery, a terminal branch of the facial artery that ascends along the side of the nose. This anastomosis further enhances the vascular network supplying the upper nasal and facial regions.
• Connection to Supratrochlear Artery: Occasionally, the dorsal nasal artery may have a connection with the supratrochlear artery, which is another terminal branch of the ophthalmic artery. This connection helps establish collateral circulation in the upper face and forehead, ensuring a consistent blood supply to these regions.

Termination

The dorsal nasal artery terminates after descending along the nasal bridge, providing small branches to the surrounding soft tissues and skin. Its anastomoses with the lateral nasal and angular arteries ensure that blood flow to the upper nose is maintained. These connections help prevent ischemia in the nasal region, even if one arterial source is compromised.

Variability

The anatomy of the dorsal nasal artery can vary slightly between individuals. Its course and size may differ, and its anastomoses with nearby arteries may be more or less prominent depending on individual variations in vascular anatomy. Despite this variability, the artery consistently supplies the nasal bridge and is an essential component of the facial blood supply.

Function

The dorsal nasal artery plays a key role in supplying blood to the upper nasal region and surrounding tissues. It is essential for maintaining the health and function of the nasal bridge, lacrimal sac, and adjacent facial structures. Below is a detailed breakdown of the specific functions of the dorsal nasal artery.

Blood Supply to the Nasal Bridge

Nourishment of the Skin and Soft Tissues of the Nasal Bridge

• One of the primary functions of the dorsal nasal artery is to supply blood to the skin and soft tissues of the nasal bridge. This area, which includes the upper bony part of the nose, relies on a steady flow of oxygenated blood to maintain the integrity and health of the overlying skin.
• The artery provides essential nutrients and oxygen, ensuring that the skin remains healthy, supports tissue repair, and maintains its structural integrity. This blood supply also helps the nasal tissues recover from minor injuries or surgical procedures.

Support for Structural Integrity

• By providing vascularization to the nasal bridge, the dorsal nasal artery helps maintain the structural integrity of the nasal framework. The artery supplies blood to the skin and superficial tissues over the nasal bones, which are responsible for shaping and supporting the upper portion of the nose.
• Adequate blood flow from the dorsal nasal artery ensures that the nasal bridge remains functional and aesthetically normal, particularly after injuries or surgeries such as rhinoplasty.

Blood Supply to the Lacrimal Sac

Vascularization of the Lacrimal Sac

• The dorsal nasal artery gives off small branches that supply the lacrimal sac, a structure that plays a key role in tear drainage. The lacrimal sac collects tears from the eye and drains them into the nasolacrimal duct, which empties into the nasal cavity.
• By supplying blood to the lacrimal sac, the dorsal nasal artery supports the normal function of the tear drainage system, ensuring that the eye remains properly lubricated and that excess tears are efficiently drained.

Contribution to Collateral Circulation in the Nasal Region

Anastomosis with the Lateral Nasal Artery

• The dorsal nasal artery forms an important anastomosis with the lateral nasal artery, a branch of the facial artery. This connection provides a dual blood supply to the nasal bridge, ensuring that oxygenated blood reaches the area from both the ophthalmic and facial arterial systems.
• This collateral circulation is particularly important for maintaining the blood supply in case of trauma or injury to one of the arteries. If one artery is damaged, the anastomosis allows the other to compensate, preventing ischemia (lack of blood flow) and tissue damage.

Anastomosis with the Angular Artery

The dorsal nasal artery may also connect with the angular artery, a terminal branch of the facial artery that supplies the side of the nose and cheek. This additional anastomosis provides further vascular support to the nasal region, ensuring consistent blood flow even in cases of arterial compromise.

Support for Healing and Regeneration

Wound Healing in the Nasal Region

• The dorsal nasal artery plays an important role in wound healing in the upper nasal region. By delivering oxygenated blood and essential nutrients to the tissues, the artery supports the body’s natural healing processes. This function is especially important in cases of trauma or surgery, such as rhinoplasty or facial fractures, where the nasal bridge or surrounding tissues may be damaged.
• Proper blood flow from the dorsal nasal artery ensures that the skin and soft tissues can repair themselves effectively, reducing the risk of complications and promoting faster recovery.

Blood Supply to the Medial Canthus Region

Vascularization of the Medial Canthus

• The dorsal nasal artery supplies blood to the area around the medial canthus, where the upper and lower eyelids meet. This region includes important structures like the lacrimal sac and medial palpebral ligament, both of which rely on a healthy blood supply for proper function.
• By nourishing the tissues in this region, the dorsal nasal artery helps maintain the integrity of the medial canthus and supports the tear drainage system.

Contribution to Facial Aesthetics and Function

Supporting Nasal Appearance and Function

• The dorsal nasal artery contributes to both the aesthetic appearance and functional health of the nasal bridge. A well-vascularized nasal region ensures that the skin remains healthy, the tissues are resilient, and the nasal framework maintains its shape. This is particularly important in facial procedures or after trauma when the artery’s blood supply supports healing and recovery.
• By maintaining the health of the nasal bridge, the dorsal nasal artery also helps preserve nasal function, such as breathing and airflow through the nasal passages.

Role in Nasal Thermoregulation

Thermoregulation of the Nasal Bridge

• The nasal region is involved in thermoregulation, where blood flow helps maintain temperature balance. The dorsal nasal artery contributes to this by providing blood to the nasal bridge, helping dissipate heat when necessary and maintaining overall thermal balance in the facial region.
• Proper blood flow from the dorsal nasal artery ensures that the nose can adjust to different environmental temperatures and play its role in body temperature regulation.

Clinical Significance

The dorsal nasal artery is clinically significant due to its role in supplying blood to the upper nasal bridge, the medial canthus region, and the lacrimal sac. Its involvement in facial surgeries, such as rhinoplasty or reconstructive procedures, makes it an important vessel to consider, as damage to this artery can result in bleeding, hematoma formation, or impaired healing in the nasal region. The artery’s location near the medial canthus also makes it vulnerable during procedures involving the tear drainage system or during trauma to the area.

Furthermore, the dorsal nasal artery forms important anastomoses with the lateral nasal artery and the angular artery, which helps ensure consistent blood flow to the nasal and facial regions, even if one artery is compromised. This anastomotic network is crucial in maintaining the vascular health of the nose, especially in cases of injury or surgery. Injury or occlusion of the dorsal nasal artery can impact the nasal region’s appearance, healing, and function, making it an essential consideration in both cosmetic and medical treatments involving the face.