Columellar artery: blood supply to the nasal tip
- Artery
Quick facts
- Origin
- Branch of the superior labial artery, usually one on each side, near the midline of the lip.
- Course
- Runs up the base and body of the columella to the nasal tip.
- Territory
- Columella and part of the nasal tip.
- Communications
- Joins the network of the lateral nasal artery and the dorsal nasal artery at the tip.
- Relevance in facial harmonization
- The nasal tip has terminal blood supply and firm skin, which raises the risk of ischemia.
The columellar artery is a small branch of the superior labial artery that runs up the columella, the bridge of tissue between the two nostrils, to the nasal tip. There is usually one on each side, near the midline. Together with branches of the lateral nasal artery and the dorsal nasal artery, it forms the network that supplies the tip. In facial harmonization, it is a basic piece of anatomy for anyone studying nonsurgical rhinoplasty.
Where does it come from and what is its course?
| Segment | What to note |
|---|---|
| Origin | Superior labial artery, a branch of the facial artery, near the midline of the lip |
| Base of the columella | Enters the columella next to the subnasale point |
| Body of the columella | Runs up in a superficial plane, one vessel on each side of the midline |
| Tip | Branches and joins the network of the lateral and dorsal nasal arteries |
The number and caliber vary: some people have one dominant vessel, double vessels on each side, or marked asymmetry between the sides. The superior labial artery may also give branches to the nasal septum, near the base of the columella.
Why does the blood supply of the tip matter?
The nasal tip is an area of thick, gland-rich, not very elastic skin sitting on the alar cartilages. The blood supply comes through a few small-caliber vessels that meet there, coming from below (columellar), from the sides (lateral nasal) and from above (dorsal). This has practical consequences:
- Little reserve: obstruction or compression of one branch has little local compensation, which favors ischemia.
- Little room: the firm skin of the tip does not stretch, and volume in this area increases pressure on the vessels.
- Link to the ophthalmic system: through the dorsal nasal artery, the tip's network communicates with the ophthalmic artery, the basis of the risk of visual complications in nasal procedures.
- Previous surgery: in open rhinoplasty, the incision in the columella usually interrupts the columellar arteries, and the tip then depends more on the lateral nasal arteries.
How does it show up in the assessment?
- History of rhinoplasty, especially open, with a scar on the columella.
- Thickness and color of the tip skin, at rest and under light pressure.
- Previous injectable procedures in the nose.
- Basal view: shape of the columella and the nostrils.
The recognition and management protocol is in nasal vascular occlusion.
Also called: artery of the columella, columellar branch of the superior labial artery.
Frequently asked questions
Where does the columellar artery come from?
It is usually a branch of the superior labial artery, which in turn arises from the facial artery. There is usually one on each side, running up the columella to the nasal tip, with variation in number and caliber.
Why is the nasal tip a necrosis risk area?
Because the tip is supplied by few small-caliber vessels, such as the columellar arteries and branches of the lateral nasal, and the skin there is thick and not very elastic. Any compression or obstruction has little room for compensation, which favors ischemia.