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压电骨刀颏成形术降低术后发病率并提高患者满意度:一项随机临床试验

Piezotome Genioplasty Reduces Postsurgical Morbidity and Enhances Patient Satisfaction: A Randomized Clinical Trial.

作者信息

Troedhan Angelo

机构信息

Visiting Professor, Department of Maxillofacial Surgery and Dentistry, Health Science University, Vientiane, Laos; Senior Physician, "Krankenhaus Hietzing", Institute for Oral and Maxillofacial Surgery and Dentistry, Vienna, Austria; Conciliar Specialist, OMF Surgery of the General Hospital "Krankenhaus der Barmherzigen Brueder Eisenstadt", Eisenstadt, Austria.

出版信息

J Oral Maxillofac Surg. 2018 Jul;76(7):1564.e1-1564.e12. doi: 10.1016/j.joms.2018.02.015. Epub 2018 Feb 27.

Abstract

PURPOSE

Recent clinical studies have shown piezotomes might establish the new "state of the art" for osteotomies in maxillofacial surgery. The author hypothesized genioplasty surgery with piezotomes might decrease postsurgical morbidity and increase overall patient satisfaction compared with genioplasty with traditional instruments.

MATERIALS AND METHODS

The author implemented a randomized clinical trial. The sample was composed of patients undergoing reductive genioplasty. The predictor variable was genioplasty performed with traditional instruments and a traditional sliding genioplasty protocol (control group) or ultrasonic surgical devices (Piezotome II and Piezotome SOLO M+) with a piezotome-adapted 3-dimensional curved osteotomy surgical protocol (test group). The primary outcome variable was overall long-term patient satisfaction determined by the Genioplasty Outcome Evaluation. Other study variables were postsurgical morbidity assessed by the Universal Pain Assessment Scale, analgesic intake, neurosensory 2-point discrimination test of the lip and chin, and surgery duration. Descriptive and bivariate statistics were computed by SPSS 22.0 and the P value was set at .05.

RESULTS

The sample was composed of 48 patients undergoing reductive genioplasty with a piezotome (10 men and 13 women; age, 24 to 56 yr) or traditional sliding genioplasty (11 men and 14 women; age, 26 to 54 yr). No statistically relevant difference was found for surgery duration between the test and control groups. There was a statistically significant association between decreased postsurgical morbidity (P < .05) and higher overall long-term patient satisfaction with genioplasty outcome (P < .05) when piezotomes were used for performing the genioplasty.

CONCLUSION

The results of this study suggest the use of piezotomes and piezotome-adapted surgical protocols is advantageous in genioplasty surgery compared with traditional surgical instruments and traditional surgical protocols.

摘要

目的

近期临床研究表明,超声骨刀可能为颌面外科截骨术建立新的“先进水平”。作者推测,与使用传统器械进行颏成形术相比,使用超声骨刀进行颏成形术可能会降低术后发病率并提高患者总体满意度。

材料与方法

作者实施了一项随机临床试验。样本由接受颏部缩小成形术的患者组成。预测变量为采用传统器械和传统滑动颏成形术方案进行的颏成形术(对照组),或采用超声外科设备(超声骨刀II型和超声骨刀SOLO M+)及适配超声骨刀的三维弧形截骨手术方案进行的颏成形术(试验组)。主要结局变量为由颏成形术结果评估确定的患者总体长期满意度。其他研究变量包括通过通用疼痛评估量表评估的术后发病率、镇痛药物摄入量、唇部和颏部的神经感觉两点辨别试验以及手术持续时间。采用SPSS 22.0进行描述性和双变量统计,P值设定为0.05。

结果

样本包括48例接受超声骨刀颏部缩小成形术的患者(10例男性和13例女性;年龄24至56岁)或传统滑动颏成形术的患者(11例男性和14例女性;年龄26至54岁)。试验组和对照组之间的手术持续时间未发现统计学上的显著差异。当使用超声骨刀进行颏成形术时,术后发病率降低(P < 0.05)与患者对颏成形术结果的总体长期满意度较高(P < 0.05)之间存在统计学上的显著关联。

结论

本研究结果表明,与传统手术器械和传统手术方案相比,使用超声骨刀及适配超声骨刀的手术方案在颏成形术中具有优势。

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