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Facial Plast Surg 2015; 31(05): 553-560
DOI: 10.1055/s-0035-1562877
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Similar Fracture Patterns in Human Nose and Gothic Cathedral

Shu Jin Lee
1   Division of Surgery, Yong Loo Lin School of Medicine, National University Health System, Singapore
2   Division of Aesthetic, Plastic and Reconstructive Surgery, University Surgical Cluster, National University Health System, Singapore
,
Kwong Ming Tse
3   Department of Mechanical Engineering, National University of Singapore, Singapore
,
Heow Pueh Lee
3   Department of Mechanical Engineering, National University of Singapore, Singapore
› Author Affiliations
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Publication History

Publication Date:
18 November 2015 (online)

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Abstract

This study proposes that the bony anatomy of the human nose and masonry structure of the Gothic cathedral are geometrically similar, and have common fracture patterns. We also aim to correlate the fracture patterns observed in patients' midface structures with those seen in the Gothic cathedral using computational approach. CT scans of 33 patients with facial fractures were examined and compared with computer simulations of both the Gothic cathedral and human nose. Three similar patterns were found: (1) Cracks of the nasal arch with crumpling of the vertical buttresses akin to the damage seen during minor earthquakes; (2) lateral deviation of the central nasal arch and collapse of the vertical buttresses akin to those due to lateral forces from wind and in major earthquakes; and (3) Central arch collapse seen as a result of collapse under excessive dead weight. Interestingly, the finding of occult nasal and septal fractures in the mandible fractures with absence of direct nasal trauma highlights the possibility of transmission of forces from the foundation to the arch leading to structural failure. It was also found that the structural buttresses of the Gothic cathedral delineate the vertical buttresses in the human midface structure. These morphologic similarities between the human nose and Gothic cathedral will serve as a basis to study the biomechanics of nasal fractures. Identification of structural buttresses in a skeletal structure has important implications for reconstruction as reestablishment of structural continuity restores normal anatomy and architectural stability of the human midface structure.

Keywords

nasal fracture - maxillofacial injury - CT - finite element - head model
 

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