Kandemir Süheyla, Özdemir Adnan, Caner Lütfiye Nisa, Deniz Berkant Kubilay, Bayar Muluk Nuray, Taş Burak Mustafa, Şencan Ziya, Cömert Ela
Department of Otorhinolaryngology, Faculty of Medicine, Kırıkkale University, 71450, Yahşihan, Kırıkkale, Turkey.
Department of Radiology, Faculty of Medicine, Kırıkkale University, 71450, Yahşihan, Kırıkkale, Turkey.
Aesthetic Plast Surg. 2025 Sep 4. doi: 10.1007/s00266-025-05191-2.
The aim of this study is to compare the radiological measurements of patients who underwent rhinoplasty using a piezo device with those of patients who underwent rhinoplasty using a classical osteotome.
A total of 60 patients were included in the study: 30 rhinoplasty patients who underwent piezosurgical osteotomy and 30 who underwent classical osteotomy. Preoperative and postoperative functional and aesthetic outcomes were compared using NOSE and ROE scores. Four anthropometric parameters were measured radiologically before and after surgery: nasofrontal angle (NFA), nasal bone length (NL), pyramidal angle (PA) and the closest distance between the nasolacrimal canal and the rhinoplasty fracture line (N-R). The pyramidal angle (PA) was measured separately at two levels: at the nasal root (PA-R) and at the tip of the nasal bone (PA-T).
The two groups were similar in terms of age, gender, and follow-up period (p > 0.05). The operative time was significantly longer in the Piezo group (p < 0.001). Preoperative and postoperative ROE values, as well as preoperative NOSE values, were comparable between the two groups (p > 0.05). However, postoperative NOSE values were statistically significantly lower in the Piezo group compared to the Osteotome group (p = 0.004). Surgery significantly affected both NOSE and ROE values in each group (p < 0.001). No statistically significant differences were found between the groups in terms of preoperative and postoperative NFA, PA-R, and PA-T values (p > 0.05). Preoperative NL values were also similar between the groups; however, postoperative NL values were significantly shorter in the Piezo group (p < 0.001). A statistically significant difference was observed in both right and left side N-R values between the groups (right: p = 0.025; left: p = 0.010), with the N-R distance being shorter in the Piezo group.
The long-term aesthetic outcomes of the piezosurgery and conventional osteotomy groups were similar; however, the piezosurgery group demonstrated better functional results. The safe margin for the nasolacrimal canal was narrower when osteotomy was performed using piezosurgery. This finding warrants caution regarding potential complications in the lacrimal system.
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 .
本研究旨在比较使用压电装置进行鼻整形术的患者与使用传统骨凿进行鼻整形术的患者的放射学测量结果。
本研究共纳入60例患者：30例行压电手术截骨的鼻整形患者和30例行传统截骨的患者。使用鼻功能和外形评价（NOSE）评分及鼻外形评价（ROE）评分比较术前和术后的功能及美学效果。术前和术后通过放射学测量四个人体测量参数：鼻额角（NFA）、鼻骨长度（NL）、锥体角（PA）以及鼻泪管与鼻整形骨折线之间的最短距离（N-R）。锥体角（PA）在两个水平分别测量：鼻根处（PA-R）和鼻骨尖端处（PA-T）。
两组在年龄、性别和随访时间方面相似（p>0.05）。压电组的手术时间明显更长（p<0.001）。两组之间术前和术后的ROE值以及术前的NOSE值相当（p>0.05）。然而，与骨凿组相比，压电组术后的NOSE值在统计学上显著更低（p = 0.004）。手术对每组的NOSE和ROE值均有显著影响（p<0.001）。两组在术前和术后的NFA、PA-R和PA-T值方面未发现统计学上的显著差异（p>0.05）。两组术前的NL值也相似；然而，压电组术后的NL值明显更短（p<0.001）。两组在右侧和左侧的N-R值上均观察到统计学上的显著差异（右侧：p = 0.025；左侧：p = 0.010），压电组的N-R距离更短。
压电手术组和传统截骨组的长期美学效果相似；然而，压电手术组显示出更好的功能效果。使用压电手术进行截骨时，鼻泪管的安全 margins 更窄。这一发现提示在泪道系统潜在并发症方面需谨慎。
证据水平 II：本刊要求作者为每篇文章指定证据水平。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 。
