Hyper-activated depressor septi nasi is an important factor
caused a nasal tip drooping and many studies have been
carried out, however it still remains controversial. This study
presents a surgical modality for its intervention, based on the
anatomical study. Eleven fixed and six fresh cadavers were
used for the study. We found that the depressor septi nasi was
consisted of three fascicles. Medial fascicles were inserted into
the dermocartilaginous ligament, and deep fibers of the medial
fascicles were attached to the anterior nasal spine. After superficial
fibers were interdigitated with the orbicularis oris, they were
attached to the alveolar bone. Intermedial fascicles were
inserted to the footplates of the medial cruses and the caudal
septum. After they were interdigitated with the medial fascicle
and the orbicularis oris, they were attached to the alveolar bone.
From April to August 2008, five patients had surgical intervention
for hyper-activated depressor septi nasi. Medial and
intermedial fascicles were detached completely from the anterior
nasal spine and the septum through intranasal approach. Tip
droopings were improved in all cases. Specific complications
were not found. We believe that surgical intervention through
intranasal approach is a useful method for correction of tip
drooping.