Laboratory of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece,
424 Army General Training Hospital, Thessaloniki, Greece.
ORL J Otorhinolaryngol Relat Spec. 2020;82(4):216-234. doi: 10.1159/000506707. Epub 2020 Apr 22.
Osteotomy of nasal bones in rhinoplasty is associated with postsurgical morbidities. Recent evidence has suggested that a surgical method applying piezoelectric ultrasound waves for nasal osteotomies in rhinoplasty reduces soft tissue damage and causes less postsurgical morbidities compared to conventional methods. The purpose of this study is to compare clinical outcomes of piezoelectric and conventional lateral nasal osteotomies in rhinoplasty.
We searched PubMed, CENTRAL, and Web of Science up to 17 August 2019 for studies comparing postoperative outcomes of piezoelectric and conventional lateral osteotomies in rhinoplasty. We included studies comparing results of patients subjected to piezoelectric or conventional lateral nasal osteotomies in rhinoplasty. For outcomes, we considered postoperative pain, eyelid edema, periorbital ecchymosis, and intraoperative mucosal injury.
For eyelid edema, a statistically significant difference in favor of piezoelectric osteotomy was documented within the first 3 postoperative days (standardized mean difference [SMD] = -0.65; 95% CI = -1.18, -0.12, p = 0.02; I2 = 69%) and on postoperative day 7 (SMD = -0.69; 95% CI = -1.47, -0.09; p = 0.08; I2 = 85%). This was also the case for periorbital ecchymosis within the first 3 postoperative days (SMD = -0.85; 95% CI = -1.42, -0.28; p = 0.004; I2 = 72%) and on postoperative day 7 (SMD = -0.52; 95% CI = -0.79, -0.24; p = 0.0003; I2 = 71%). Intraoperative mucosal injury (OR = 0.06; 95% CI = 0.01, 0.53; p = 0.01; Ι2 = 0%) and postoperative pain (SMD = -0.99; 95% CI = -1.78, -0.11; p = 0.01; I2 = 49%) were also statistically lower during piezoelectric osteotomies.
This study shows that lateral piezoelectric osteotomy in rhinoplasty decreases postoperative pain, edema, ecchymosis, and intraoperative mucosa injuries compared to the conventional osteotomy technique with a chisel. Piezoelectric osteotomies are especially associated with less postoperative edema and ecchymosis in osteotomies not executed under direct vision.
鼻整形术中的鼻骨截骨术与术后并发症有关。最近的证据表明，与传统方法相比，应用压电超声波进行鼻整形术的截骨术可减少软组织损伤并引起较少的术后并发症。本研究旨在比较鼻整形术中压电和传统侧鼻截骨术的临床效果。
我们检索了 PubMed、CENTRAL 和 Web of Science，截至 2019 年 8 月 17 日，以查找比较鼻整形术中外压电和传统侧鼻截骨术术后结果的研究。我们纳入了比较接受压电或传统侧鼻截骨术的患者结果的研究。对于结果，我们考虑了术后疼痛、眼睑肿胀、眶周瘀斑和术中粘膜损伤。
术后 3 天内，眼睑肿胀方面，压电截骨术具有统计学意义（标准化均数差[SMD] = -0.65；95%置信区间[CI] = -1.18，-0.12，p = 0.02；I2 = 69%）和术后第 7 天（SMD = -0.69；95%CI = -1.47，-0.09；p = 0.08；I2 = 85%）。术后 3 天内眶周瘀斑（SMD = -0.85；95%CI = -1.42，-0.28；p = 0.004；I2 = 72%）和术后第 7 天（SMD = -0.52；95%CI = -0.79，-0.24；p = 0.0003；I2 = 71%）也有统计学意义。术中粘膜损伤（OR = 0.06；95%CI = 0.01，0.53；p = 0.01；I2 = 0%）和术后疼痛（SMD = -0.99；95%CI = -1.78，-0.11；p = 0.01；I2 = 49%）在压电截骨术中也有统计学意义。
本研究表明，与传统的骨凿截骨术相比，鼻整形术中的外侧压电截骨术可减少术后疼痛、肿胀、瘀斑和术中粘膜损伤。与传统截骨术相比，压电截骨术尤其与非直视下截骨术的术后肿胀和瘀斑减少有关。
