Published online May 28, 2016. doi: 10.5319/wjo.v6.i2.33
Peer-review started: September 17, 2015
First decision: November 27, 2015
Revised: March 4, 2016
Accepted: March 17, 2016
Article in press: March 18, 2016
Published online: May 28, 2016
Aim was to gather relevant knowledge in evolution and development to find a rational explanation for the intricate and elaborate anatomy of the nose. According to classic embryology, the philtrum of the upper lip, nasal dorsum, septum and primary palate develop from the intermaxillary process, and the lateral walls of the nasal pyramid from the lateral nasal processes. The palatal shelves, which are outgrowths of the maxillary processes, form the secondary palate. The median nasal septum develops inferiorly from the roof of the nasal cavity. These valuable embryologic data do not explain the complex intricacy of the many anatomical structures comprising the nose. The evo-devo theory offers a rational explanation to this complex anatomy. Phylogenically, the nose develops as an olfactory organ in fish before becoming respiratory in tetrapods. During development, infolding of the olfactory placodes occurs, bringing the medial olfactory processes to form the septolateral cartilage while the lateral olfactory processes form the alar cartilages. The olfactory fascia units these cartilages to the olfactory mucosa, that stays separated from brain by the cartilaginous olfactory capsule (the ethmoid bone forerunner). Phylogenically, the respiratory nose develops between mouth and olfactory nose by rearrangement of the dermal bones of the secondary palate, which appears in early tetrapods. During development, the palatal shelves develop into the palatine processes of the maxillary bones, and with the vomer, palatine, pterygoid and inferior turbinate bones form the walls of the nasal cavity after regression of the transverse lamina. Applying the evolutionary developmental biology (evo-devo) discipline on our present knowledge of development, anatomy and physiology of the nose, significantly expands and places this knowledge in proper perspective. The clinicopathologies of nasal polyposis, for example, occurs specifically in the ethmoid labyrinth or, woodworker’s adenocarcinomas, occurring only in the olfactory cleft can now be explained by employing the evo-devo approach. A full understanding of the evo-devo discipline, as it pertains to head and neck anatomy, has profound implications to the otolaryngologist empowering his skills and abilities, and ultimately translating in improving surgical outcomes and maximizing patient care.
Core tip: The intricate and elaborate anatomy of the human nose can be best understood by gathering knowledge in evolution and development. Phylogenically and ontogenically, the nose results from two distinct entities: The olfactory and respiratory organ. In vertebrates, the olfactory placodes give rise to the fibrocartilaginous nose made of alar and septolateral cartilages, olfactory mucosa and the olfactory fascia; the respiratory nose develops by evolutionary remodeling of the palatal bones under the olfactory nose. In humans, the mammalian olfactory chambers are transformed into olfactory clefts and lateral masses of the ethmoid, and the transverse lamina separating the olfactory and respiratory noses has disappeared.