Robotti Enrico, Khazaal Ali, Leone Francesco, De Bernardis Riccardo, Nolli Mattia, Robotti Sara, Cottone Giuseppe
Private Practice at Clinica Villa Sant'Apollonia, Via Giovanni Motta, 37, 24123, Bergamo, BG, Italy.
Private Practice, Baghdad, Iraq.
Aesthetic Plast Surg. 2025 Feb;49(3):690-704. doi: 10.1007/s00266-024-04278-6. Epub 2024 Aug 8.
Over the past decade, rhinoplasty has seen an unprecedented evolution in concepts, techniques and tools. New concepts have led to new techniques, prevalently but not exclusively related to preservation rhinoplasty, and the use of new tools has made such techniques easier, more precise and thus better reproducible. Power tools can presently be considered only relatively new, while Piezo has gained great popularity over the last years.
This article is focused on how power tools (diverse burrs with specific spherical, cylindrical, conical, discoid tips) can be integrated efficiently together with the use of Piezo and its different inserts in a logical and effective manner.
This combination should be implemented in a progressive fashion into specific steps of surgery, although, in general, burrs should be used for reshaping and piezo for cutting bone. Specific and notable exceptions to this rule will be mentioned in the paper. Obviously, cost should be considered, but the benefits are evident: heightened control, reduced asymmetries, smoother bony and middle vault contour, and a more precise management of septum and turbinates. We have come to this conclusion following the combined experience of the two centers participating in the study, with over 350 patients over the last three years.
The article focuses on the modified dorsal split preservation hybrid rhinoplasty favored by the senior author, but its principles will easily apply to any structural, preservation, or hybrid rhinoplasty.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
在过去十年中，隆鼻术在概念、技术和工具方面经历了前所未有的发展。新的概念催生了新技术，这些技术主要但不限于与保留性隆鼻术相关，并且新工具的使用使这些技术更易于操作、更精确，从而更具可重复性。动力工具目前只能算是相对较新的，而压电技术在过去几年中广受欢迎。
本文重点探讨动力工具（具有特定球形、圆柱形、圆锥形、盘状尖端的各种磨头）如何与压电技术及其不同的刀片以合理有效的方式高效结合使用。
这种组合应以渐进的方式应用于手术的特定步骤，不过一般来说，磨头用于重塑，压电技术用于切割骨头。本文将提及该规则的具体显著例外情况。显然，成本应予以考虑，但好处是显而易见的：更好的控制、减少不对称性、使鼻骨和鼻中段轮廓更平滑，以及对鼻中隔和鼻甲进行更精确的处理。我们是在参与研究的两个中心的综合经验基础上得出这一结论的，在过去三年中有超过350例患者。
本文重点介绍资深作者所青睐的改良背侧劈开保留性混合隆鼻术，但其原则可轻松应用于任何结构性、保留性或混合性隆鼻术。
证据级别V：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
