Plastic Surgery Unit at Meir Medical Center, Kfar Saba, Israel.
Aesthet Surg J. 2013 Aug 1;33(6):809-16. doi: 10.1177/1090820X13496250. Epub 2013 Jul 12.
Placement of diced cartilage enclosed within an autologous fascia sleeve (DC-F) for nasal dorsum reconstruction is common in open rhinoplasty, but there are no data regarding its use in closed rhinoplasty (the endonasal approach).
The authors describe a technique for augmenting the nasal dorsum in secondary rhinoplasty with DC-F grafts via an endonasal approach.
In this study, the authors retrospectively review the cases of 18 patients who underwent closed rhinoplasty with the authors' technique between 2008 and 2011. Cartilage harvested from the septum, rib, or concha was diced into 0.5- to 1-mm cubes. A rectangle of deep temporal fascia (approximately 5 × 5 cm) was harvested by means of a single V-shaped incision overlying the temporal fossa, then wrapped around another 1-mL syringe and secured. The fascial cylinder was filled with the desired amount of diced cartilage and then sutured closed at both ends. This graft was placed into the dorsum of the nose via the endonasal approach.
Average age of the patients was 32 years. The patients were followed for a minimum of 15 months. Donor site for cartilage harvest was conchal in 8 patients, septal and conchal in 6 cases, and costal in 4. Complications were encountered in 3 patients, only 1 of whom required surgical revision for contour irregularity. No resorption of cartilage was encountered in any patient after 15 months. Smooth continuity of the nasal dorsum was achieved in all our patients.
Despite the lack of a large volume of patients for overwhelming and conclusive results, our study provides further confirmation that this technique is indeed an attractive option for nasal dorsum reconstruction.
在开放式鼻整形术中，将包裹在自体筋膜袖内的软骨块（DC-F）置于鼻背进行重建较为常见，但在闭合式鼻整形术（经鼻内入路）中，尚无相关使用数据。
作者介绍了一种经鼻内入路，使用 DC-F 移植物增强二次鼻整形术鼻背的技术。
在这项研究中，作者回顾性分析了 2008 年至 2011 年间采用作者技术行闭合式鼻整形术的 18 例患者的病例。从鼻中隔、肋软骨或鼻甲采集的软骨被切成 0.5-1mm 的小块。通过在颞窝上方做一个单一的 V 形切口，切取一块大约 5×5cm 的颞深筋膜，然后将其包裹在另一个 1ml 注射器上并固定。将筋膜圆柱填充所需量的软骨块，然后将两端缝合。通过经鼻内入路将移植物置于鼻背。
患者的平均年龄为 32 岁。患者的随访时间至少为 15 个月。软骨采集的供区为 8 例患者的耳甲，6 例鼻中隔和耳甲，4 例肋软骨。3 例患者发生并发症，仅 1 例因轮廓不规则需要手术修复。15 个月后，所有患者均未发生软骨吸收。所有患者的鼻背均实现了光滑连续。
尽管缺乏大量患者的数据，无法得出压倒性和结论性的结果，但本研究进一步证实，该技术确实是一种有吸引力的鼻背重建选择。
