Skip to main content
Erschienen in: European Archives of Oto-Rhino-Laryngology 6/2017

11.03.2017 | Rhinology

A comparison of piezosurgery with conventional techniques for internal osteotomy

verfasst von: İ. Koçak, R. Doğan, O. Gökler

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p < 0.05). On postoperative day 2, the pain level was lower in the piezosurgery group than in the conventional osteotomy group (p < 0.05). In an endoscopic examination on postoperative day 4, while 24% of the patients in the conventional osteotomy group had mucosal damage, no such damage was observed in the piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.
Literatur
1.
Zurück zum Zitat Kienstra MA, Sherris DA, Kern EB (1999) Ostetomy and pyramid modification in the Joseph and Cottle rhinoplasty. Facial Plast Surg Clin North Am 7:279–294 Kienstra MA, Sherris DA, Kern EB (1999) Ostetomy and pyramid modification in the Joseph and Cottle rhinoplasty. Facial Plast Surg Clin North Am 7:279–294
2.
Zurück zum Zitat Halewyck S, Michel O, Daele J, Gordts F (2010) A review of nasal dorsal hump reduction techniques, with a particular emphasis on a comparison of component and composite removal. B-ENT 6(Suppl 15):41–48PubMed Halewyck S, Michel O, Daele J, Gordts F (2010) A review of nasal dorsal hump reduction techniques, with a particular emphasis on a comparison of component and composite removal. B-ENT 6(Suppl 15):41–48PubMed
3.
Zurück zum Zitat Giacomarra V, Russolo M, Arnez ZM et al (2001) External osteotomy in rhinoplasty. Laryngoscope 111:433–438CrossRefPubMed Giacomarra V, Russolo M, Arnez ZM et al (2001) External osteotomy in rhinoplasty. Laryngoscope 111:433–438CrossRefPubMed
4.
5.
Zurück zum Zitat Murakami CS, Larrabee WF Jr (1992) Comparison of osteotomy techniques in the treatment of nasal fracture. Facial Plast Surg 8:209–219CrossRefPubMed Murakami CS, Larrabee WF Jr (1992) Comparison of osteotomy techniques in the treatment of nasal fracture. Facial Plast Surg 8:209–219CrossRefPubMed
6.
Zurück zum Zitat Gryskiewicz JM, Gryskiewicz KM (2004) Nasal osteotomies: a clinical comparison of the perforating methods versus the continuous technique. Plast Reconstr Surg 113:1445–1456CrossRefPubMed Gryskiewicz JM, Gryskiewicz KM (2004) Nasal osteotomies: a clinical comparison of the perforating methods versus the continuous technique. Plast Reconstr Surg 113:1445–1456CrossRefPubMed
7.
Zurück zum Zitat Trenite GJ (1991) Trauma reduction in rhinoplastic surgery. Rhinology 29:111–116 Trenite GJ (1991) Trauma reduction in rhinoplastic surgery. Rhinology 29:111–116
8.
Zurück zum Zitat Goldfarb M, Gallups LM, Gerwin JM (1993) Perforating osteotomies in rhinoplasty. Arch Otolaryngol Head Neck Surg 119:624–627CrossRefPubMed Goldfarb M, Gallups LM, Gerwin JM (1993) Perforating osteotomies in rhinoplasty. Arch Otolaryngol Head Neck Surg 119:624–627CrossRefPubMed
9.
Zurück zum Zitat Robiony M, Toro C, Costa F et al (2007) Piezosurgery: a new method for osteotomies in rhinoplasty. J Craniofac Surg 18:1098–1100CrossRefPubMed Robiony M, Toro C, Costa F et al (2007) Piezosurgery: a new method for osteotomies in rhinoplasty. J Craniofac Surg 18:1098–1100CrossRefPubMed
10.
Zurück zum Zitat Olivier Gerbault MD, Rollin K, Daniel MD (2016) The role of piezoelectric instrumentation in rhinoplasty surgery. Aesthet Surg J 36(1):21–34CrossRefPubMed Olivier Gerbault MD, Rollin K, Daniel MD (2016) The role of piezoelectric instrumentation in rhinoplasty surgery. Aesthet Surg J 36(1):21–34CrossRefPubMed
11.
Zurück zum Zitat Robiony M, Polini F, Costa F et al (2007) Ultrasound piezoelectric vibrations to perform osteotomies in rhinoplasty. J Oral Maxillofac Surg 65:1035–1038CrossRefPubMed Robiony M, Polini F, Costa F et al (2007) Ultrasound piezoelectric vibrations to perform osteotomies in rhinoplasty. J Oral Maxillofac Surg 65:1035–1038CrossRefPubMed
12.
Zurück zum Zitat Cochran CS, Roostaeian J (2013) Use of the ultrasonic bone aspiratör for lateral osteotomies in rhinoplasty. Plast Recon Surg 132(6):1430–1433CrossRef Cochran CS, Roostaeian J (2013) Use of the ultrasonic bone aspiratör for lateral osteotomies in rhinoplasty. Plast Recon Surg 132(6):1430–1433CrossRef
13.
Zurück zum Zitat Tirelli G, Tofanelli M, Bullo F, Bianchi M, Robiony M (2015) External osteotomy in rhinoplasty: piezosurgery vs osteotome. Am J Otolaryngol 36(5):666–671CrossRefPubMed Tirelli G, Tofanelli M, Bullo F, Bianchi M, Robiony M (2015) External osteotomy in rhinoplasty: piezosurgery vs osteotome. Am J Otolaryngol 36(5):666–671CrossRefPubMed
14.
Zurück zum Zitat Ilhan AE, Cengiz B, Eser BC (2016) Double-blind comparison of ultrasonic and conventional osteotomy in terms of early postoperative edema and ecchymosis. Aesthet Surg J 36(4):390–401CrossRefPubMed Ilhan AE, Cengiz B, Eser BC (2016) Double-blind comparison of ultrasonic and conventional osteotomy in terms of early postoperative edema and ecchymosis. Aesthet Surg J 36(4):390–401CrossRefPubMed
15.
Zurück zum Zitat Taşkın T, Batmaz T, Erdil M, Aydın S, Yücebaş K (2016) The comparison of edema and ecchymosis after piezoelectric and conventional osteotomy in rhinoplasty. Eur Arch Otorhinolaryngol 274(2):861–865. doi:10.1007/s00405-016-4306-9 PubMed Taşkın T, Batmaz T, Erdil M, Aydın S, Yücebaş K (2016) The comparison of edema and ecchymosis after piezoelectric and conventional osteotomy in rhinoplasty. Eur Arch Otorhinolaryngol 274(2):861–865. doi:10.​1007/​s00405-016-4306-9 PubMed
16.
Zurück zum Zitat Kara CO, Gokalan I (1999) Effects of single dose steroid usage on edema, ecchymosis and intraoperative bleeding in rhinoplasty. plastic reconstructive. Surgery 104:2213–2218 Kara CO, Gokalan I (1999) Effects of single dose steroid usage on edema, ecchymosis and intraoperative bleeding in rhinoplasty. plastic reconstructive. Surgery 104:2213–2218
17.
Zurück zum Zitat Xu F, Zeng W, Mao X et al (2008) The efficacy of melilotus extract in the management of postoperative ecchymosis and edema after simultaneous rhinoplasty and blepharoplasty. Aesth Plast Surg 32:599–603CrossRef Xu F, Zeng W, Mao X et al (2008) The efficacy of melilotus extract in the management of postoperative ecchymosis and edema after simultaneous rhinoplasty and blepharoplasty. Aesth Plast Surg 32:599–603CrossRef
18.
Zurück zum Zitat Gurlek A, Fariz A, Aydogan H, Ersöz-Oztürk A, Evans GR (2009) Effects of high dose corticosteroids in open rhinoplasty. J Plast Reconstr Aesthetic Surg 62(5):650–655CrossRef Gurlek A, Fariz A, Aydogan H, Ersöz-Oztürk A, Evans GR (2009) Effects of high dose corticosteroids in open rhinoplasty. J Plast Reconstr Aesthetic Surg 62(5):650–655CrossRef
19.
Zurück zum Zitat Totonchi A, Guyuron B (2007) A randomized, controlled comparison between arnica and steroids in the management of postrhinoplasty ecchymosis and oedema. Plast Reconstr Surg 120(1):271–274CrossRefPubMed Totonchi A, Guyuron B (2007) A randomized, controlled comparison between arnica and steroids in the management of postrhinoplasty ecchymosis and oedema. Plast Reconstr Surg 120(1):271–274CrossRefPubMed
20.
Zurück zum Zitat Saedi B, Sadeghi M, Fekri K (2011) Comparison of the effect of corticostreroid therapy and decongestant on reducing rhinoplasty edema. Am J Rhinol Allergy 25:141–144CrossRef Saedi B, Sadeghi M, Fekri K (2011) Comparison of the effect of corticostreroid therapy and decongestant on reducing rhinoplasty edema. Am J Rhinol Allergy 25:141–144CrossRef
21.
Zurück zum Zitat Kara CO, Kara IG et al (2005) Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty? J Oral Maxillofac Surg 63:1088–1090CrossRefPubMed Kara CO, Kara IG et al (2005) Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty? J Oral Maxillofac Surg 63:1088–1090CrossRefPubMed
22.
Zurück zum Zitat Becker DG, McLaughlin RB, Loevner LA et al (2000) The lateral osteotomy in rhinoplasty: clinical and radiographic rationale for osteotome selection. Plast Reconstr Surg 105:1806–1816CrossRefPubMed Becker DG, McLaughlin RB, Loevner LA et al (2000) The lateral osteotomy in rhinoplasty: clinical and radiographic rationale for osteotome selection. Plast Reconstr Surg 105:1806–1816CrossRefPubMed
23.
Zurück zum Zitat Rohrich RJ, Krueger JK, Adams WP et al (2001) Achieving consistancy in the lateral nasal osteotomy during rhinoplasty: an external perforated technique. Plast Reconstr Surg 108:2122–2132CrossRefPubMed Rohrich RJ, Krueger JK, Adams WP et al (2001) Achieving consistancy in the lateral nasal osteotomy during rhinoplasty: an external perforated technique. Plast Reconstr Surg 108:2122–2132CrossRefPubMed
24.
Zurück zum Zitat Caner Kilic MD, Umit Tuncel MD (2015) Effect of the rhinoplasty technique and lateral osteotomy on periorbital edema and ecchymosis. J Craniofac Surg 26(5):e430–e433CrossRefPubMed Caner Kilic MD, Umit Tuncel MD (2015) Effect of the rhinoplasty technique and lateral osteotomy on periorbital edema and ecchymosis. J Craniofac Surg 26(5):e430–e433CrossRefPubMed
25.
Zurück zum Zitat Mottura AA (2011) Internal lateral nasal osteotomy: double guarded osteotome and mucosa tearing. Aesthetic Plast Surg 35:171–176CrossRefPubMed Mottura AA (2011) Internal lateral nasal osteotomy: double guarded osteotome and mucosa tearing. Aesthetic Plast Surg 35:171–176CrossRefPubMed
26.
Zurück zum Zitat Rohrich RJ, Minoli JJ, Adams WP et al. The lateral nasal osteotomy in rhinoplasty. An anatomic endoscopic comparison of the external versus the internal approach. Plast Reconstr Surg 1997:1309 Rohrich RJ, Minoli JJ, Adams WP et al. The lateral nasal osteotomy in rhinoplasty. An anatomic endoscopic comparison of the external versus the internal approach. Plast Reconstr Surg 1997:1309
27.
Zurück zum Zitat Landes CA, Stübinger S, Ballon A, Sader R (2008) Piezoosteotomy in orthognathic surgery versus conventional saw and chisel osteotomy. Oral Maxillofac Surg 12(3):139–147CrossRefPubMed Landes CA, Stübinger S, Ballon A, Sader R (2008) Piezoosteotomy in orthognathic surgery versus conventional saw and chisel osteotomy. Oral Maxillofac Surg 12(3):139–147CrossRefPubMed
28.
Zurück zum Zitat Robiony M, Polini F, Costa F et al (2004) Piezoelectric bone-cutting in multipiece maxillary osteotomies. J Oral Maxillofac Surg 62(6):759–761CrossRefPubMed Robiony M, Polini F, Costa F et al (2004) Piezoelectric bone-cutting in multipiece maxillary osteotomies. J Oral Maxillofac Surg 62(6):759–761CrossRefPubMed
29.
Zurück zum Zitat Crippa B, Salzano FA, Mora R, Dellepiane M, Salami A, Guastini L (2011 Sep) Comparison of postoperative pain: piezoelectric device versus microdrill. Eur Arch Otorhinolaryngol 268(9):1279–1282CrossRefPubMed Crippa B, Salzano FA, Mora R, Dellepiane M, Salami A, Guastini L (2011 Sep) Comparison of postoperative pain: piezoelectric device versus microdrill. Eur Arch Otorhinolaryngol 268(9):1279–1282CrossRefPubMed
30.
Zurück zum Zitat Salami A, Mora R, Crippa B, Dellepiane M, Guastini L (2010) Piezoelectric stapedotomy: the importance of a micropulse program. Acta Otolaryngol 130(12):1364–1369CrossRefPubMed Salami A, Mora R, Crippa B, Dellepiane M, Guastini L (2010) Piezoelectric stapedotomy: the importance of a micropulse program. Acta Otolaryngol 130(12):1364–1369CrossRefPubMed
31.
Zurück zum Zitat Salami A, Dellepiane M, Mora R (2008) A novel approach to facial nerve decompression: use of piezosurgery. Acta Otolaryngol 128(5):530–533CrossRefPubMed Salami A, Dellepiane M, Mora R (2008) A novel approach to facial nerve decompression: use of piezosurgery. Acta Otolaryngol 128(5):530–533CrossRefPubMed
32.
Zurück zum Zitat Salami A, Dellepiane M, Salzano FA, Mora R (2009) Piezosurgery in endoscopic dacryocystorhinostomy. Otolaryngol Head Neck Surg 140(2):264–266CrossRefPubMed Salami A, Dellepiane M, Salzano FA, Mora R (2009) Piezosurgery in endoscopic dacryocystorhinostomy. Otolaryngol Head Neck Surg 140(2):264–266CrossRefPubMed
33.
Zurück zum Zitat Salami A, Dellepiane M, Crippa B, Mora R (2010) A new method for osteotomies in oncologic nasal surgery: piezosurgery. Am J Otolaryngol Head Neck Med Surg 31:150–153 Salami A, Dellepiane M, Crippa B, Mora R (2010) A new method for osteotomies in oncologic nasal surgery: piezosurgery. Am J Otolaryngol Head Neck Med Surg 31:150–153
34.
Zurück zum Zitat Gellner V, Koele W, Wolf A, Gerstenberger C, Mokry M, Stammberger H, Tomazic PV (2016) A piezoelectric device for bone work in endoscopic anterior skull base surgery—a feasibility study in 15 patients. Clin Otolaryngol. doi:10.1111/coa.12760 Gellner V, Koele W, Wolf A, Gerstenberger C, Mokry M, Stammberger H, Tomazic PV (2016) A piezoelectric device for bone work in endoscopic anterior skull base surgery—a feasibility study in 15 patients. Clin Otolaryngol. doi:10.​1111/​coa.​12760
35.
Zurück zum Zitat Pribitkin EA, Lavasani LS, Shindle C, Greywoode JD (2010) Sonic rhinoplasty: sculpting the nasal dorsum with the ultrasonic bone aspirator. Laryngoscope 120(8):1504–1507CrossRefPubMed Pribitkin EA, Lavasani LS, Shindle C, Greywoode JD (2010) Sonic rhinoplasty: sculpting the nasal dorsum with the ultrasonic bone aspirator. Laryngoscope 120(8):1504–1507CrossRefPubMed
36.
Zurück zum Zitat Vercellotti T, Crovace A, Palermo A et al (2001) The Piezoelectric osteotomy in orthopedics;clinical and histological evaluations (pilot study in animals). Mediterr J Surg Med 9:89–96 Vercellotti T, Crovace A, Palermo A et al (2001) The Piezoelectric osteotomy in orthopedics;clinical and histological evaluations (pilot study in animals). Mediterr J Surg Med 9:89–96
37.
Zurück zum Zitat Ghassemi A, Prescher A, Talebzadeh M, Hölzle F, Modabber A (2013) Osteotomy of the nasal wall using a newly designed piezo scalpel–a cadaver study. J Oral Maxillofac Surg 71(12):2155.e1-6CrossRefPubMed Ghassemi A, Prescher A, Talebzadeh M, Hölzle F, Modabber A (2013) Osteotomy of the nasal wall using a newly designed piezo scalpel–a cadaver study. J Oral Maxillofac Surg 71(12):2155.e1-6CrossRefPubMed
38.
Zurück zum Zitat Harshbarger RJ, Sullivan PK (1999) Lateral nasal osteotomies: implications of bony thickness on fracture patterns. Ann Plast Surg 42:365–370CrossRefPubMed Harshbarger RJ, Sullivan PK (1999) Lateral nasal osteotomies: implications of bony thickness on fracture patterns. Ann Plast Surg 42:365–370CrossRefPubMed
39.
Zurück zum Zitat Yosry M, Othman IS (2008) Controlled hypotension in adults undergoing choroidal melanoma resection: comparison between the efficacy of nitroprusside and magnesium sulphate. Eur J Anaesthesiol 25(11):891–896CrossRefPubMed Yosry M, Othman IS (2008) Controlled hypotension in adults undergoing choroidal melanoma resection: comparison between the efficacy of nitroprusside and magnesium sulphate. Eur J Anaesthesiol 25(11):891–896CrossRefPubMed
40.
Zurück zum Zitat Tuncel U, Turan A, Bayraktar MA (2013) Efficacy of dexamethasone with controlled hypotension on intraoperative bleeding, postoperative oedema and ecchymosis in rhinoplasty. J Cranio Maxillo Facial Surg 41(2):124–128CrossRef Tuncel U, Turan A, Bayraktar MA (2013) Efficacy of dexamethasone with controlled hypotension on intraoperative bleeding, postoperative oedema and ecchymosis in rhinoplasty. J Cranio Maxillo Facial Surg 41(2):124–128CrossRef
41.
Zurück zum Zitat Szychta P, Antoszewski B (2010) Assessment of early postoperative pain following septorhinoplasty. J Laryngol Otol 124:1194–1199CrossRefPubMed Szychta P, Antoszewski B (2010) Assessment of early postoperative pain following septorhinoplasty. J Laryngol Otol 124:1194–1199CrossRefPubMed
42.
Zurück zum Zitat Sari E, Simsek G (2015) Comparison of the effects of total nasal block and central facial block on acute postoperative pain, edema, and ecchymosis after septorhinoplasty. Aesth Plast Surg 39:877–880CrossRef Sari E, Simsek G (2015) Comparison of the effects of total nasal block and central facial block on acute postoperative pain, edema, and ecchymosis after septorhinoplasty. Aesth Plast Surg 39:877–880CrossRef
43.
Zurück zum Zitat Demirhan A, Tekelioglu UY (2013) Effect of pregabalin and dexamethasone addition to multimodal analgesia on postoperative analgesia following rhinoplasty surgery. Aesth Plast Surg 37:1100–1106CrossRef Demirhan A, Tekelioglu UY (2013) Effect of pregabalin and dexamethasone addition to multimodal analgesia on postoperative analgesia following rhinoplasty surgery. Aesth Plast Surg 37:1100–1106CrossRef
Metadaten
Titel
A comparison of piezosurgery with conventional techniques for internal osteotomy
verfasst von
İ. Koçak
R. Doğan
O. Gökler
Publikationsdatum
11.03.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 6/2017
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-017-4514-y

Weitere Artikel der Ausgabe 6/2017

European Archives of Oto-Rhino-Laryngology 6/2017 Zur Ausgabe

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.