Resolution of Posttraumatic Recurrent Nasal Fistula Using Temporoparietal Fascia

Abstract

Temporoparietal fascial grafts have been used for both nasal and facial contouring, for vascularized tissue coverage, and to augment the nose and lip. The temporoparietal fascial graft provides thin, broad, pliable, easily neovascularized, adequate coverage, contour, and bulk on the cartilage dorsum of the nose, as well as an inconspicuous donor site. A 23-year-old female motorcyclist had an accident with 1 angular laceration wound on the dorsum of the nose in 2006. There was intermittent discharge in the dorsal nose 2 weeks after primary repair. Six months later, the open-tip rhinoplasty was applied to the recurrent fistula of the nose dorsum. There were 2 fistulous orifices and 1 fibrotic cavity with hair ingrowth. After replacement of the rolled temporoparietal fascia, external nasal splinting was applied to mold the shape for 1 week. There was neither graft exposure nor recurrent infection. The procedure is a useful method to eliminate inflammatory squeals. The smooth nasal dorsum skin was regained with adequate nasal projection.