title: Dorsal augmentation with diced cartilage enclosed with temporal fascia in secondary endonasal rhinoplasty.
abstract: BACKGROUND
  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).
  
  
  OBJECTIVE
  The authors describe a technique for augmenting the nasal dorsum in secondary rhinoplasty with DC-F grafts via an endonasal approach.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Plastic Surgery Unit at Meir Medical Center, Kfar Saba, Israel.
authors.forename: Marcos
authors.initials: M
authors.lastname: Harel
authors.forename: Alexander
authors.initials: A
authors.lastname: Margulis
mesh_terms: D000293:Adolescent; D000328:Adult; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000637:transplantation*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: diced cartilage; dorsal augmentation; endonasal rhinoplasty; fascia grafts; secondary rhinoplasty