Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Laryngoscope. 2021 Jan;131(1):54-58. doi: 10.1002/lary.28519. Epub 2020 Feb 8.
Although lateral osteotomy is an important part of rhinoplasty, it is known to be closely associated with postoperative eyelid edema and ecchymosis after rhinoplasty. There is no consensus on which osteotomy methods are effective in reducing morbidity from rhinoplasty. This study compared the effects of different osteotomy methods on edema and ecchymosis after lateral osteotomy using a meta-analysis.
A literature search using MEDLINE, SCOPUS, and Cochrane databases.
Two authors independently reviewed the databases published until May 2019. Randomized controlled trials that compared lateral osteotomy methods (external approach) with different methods (internal approach), for which the outcomes of interest were mucosal injury, edema, and ecchymosis on postoperative days, were included. Sufficient data for meta-analysis was found in six studies with a total of 224 patients.
In a comparison of the external approach with the internal approach, mucosal injury was significantly lower in the external approach (odds ratio = 0.41; 95% confidence interval = [0.11; 0.99], I = 29%). There were significant differences between the external and internal approach in eyelid ecchymosis and edema, except for eyelid ecchymosis at 7 days postoperatively. However, all significant results showed a small effect size with a standardized mean difference near 0.2.
The external approach during lateral osteotomy had no significant advantage in edema and ecchymosis compared to the internal approach. Further studies with good research methodology should be carried out to determine the effect on the postoperative complications of different lateral osteotomy methods. Laryngoscope, 131:54-58, 2021.
尽管外侧截骨术是鼻整形术的重要组成部分，但众所周知，它与鼻整形术后的眼睑水肿和瘀斑密切相关。目前尚无共识认为哪种截骨方法能有效降低鼻整形术的发病率。本研究通过荟萃分析比较了不同截骨方法对外侧截骨术后水肿和瘀斑的影响。
使用 MEDLINE、SCOPUS 和 Cochrane 数据库进行文献检索。
两位作者独立审查了截至 2019 年 5 月发表的数据库。纳入了比较外侧截骨术（外切法）与不同方法（内切法）的随机对照试验，其感兴趣的结局为术后第几天的黏膜损伤、水肿和瘀斑。有 6 项研究共 224 例患者有足够的数据进行荟萃分析。
与内切法相比，外切法的黏膜损伤显著降低（比值比=0.41；95%置信区间[0.11；0.99]，I²=29%）。除术后第 7 天外，外切法和内切法在眼睑瘀斑和水肿方面存在显著差异，但所有显著结果的效应量均较小，标准化均数差接近 0.2。
与内切法相比，外侧截骨术中的外切法在水肿和瘀斑方面没有显著优势。应该进行具有良好研究方法的进一步研究，以确定不同外侧截骨方法对术后并发症的影响。喉科学杂志，131:54-58,2021。
