Double-Blind Comparison of Ultrasonic and Conventional Osteotomy in Terms of Early Postoperative Edema and Ecchymosis

İlhan, A. Emre; Cengiz, Betül; Eser, Başak Çaypınar

doi:10.1093/asj/sjv260

Cited by 55 publications

(70 citation statements)

References 31 publications

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“…Conventional osteotomy can cause bleeding into the soft tissue owing to disruption of the angular artery or vein. By contrast, piezosurgical devices have been reported to decrease intraoperative bleeding by minimising injury to vessels and soft tissue in proximity to osteotomies . This discrepancy could explain the high effect size of the piezosurgical device in ecchymosis.…”

Section: Discussionmentioning

confidence: 98%

“…Oedema and ecchymosis were reported to reach a peak level within 3 days postoperatively and persist until day 9 . For these reasons, we used two time categories to reflect more exactly the time‐dependent change of effect of piezoelectric osteotomy on postoperative morbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Data from the included studies were extracted using standardised forms and checked by two reviewers independently. The primary outcomes were degree of intraoperative mucosal injury, operative time, eyelid oedema, periorbital soft tissue ecchymosis and postoperative pain comparing piezoelectric osteotomy vs control (conventional osteotomy) during the postoperative period (within 3 days or postoperative day 7). Oedema and ecchymosis of the eyelids were evaluated separately using graded scales.…”

Section: Methodsmentioning

confidence: 99%

“…A careful surgical approach can help decrease this injury, but it may not be possible to prevent it completely. Recently, piezoelectric osteotomy was introduced as an alternative osteotomy method, including external percutaneous osteotomy in various countries . The piezoelectric effect, first described by Jean and Marie Curie in 1880, occurs when certain mineralised tissues deform when an electric current is passed across them by oscillations of ultrasonic frequency.…”

Section: Introductionmentioning

confidence: 99%

“…There have been new studies on the advantages of piezoelectric surgery compared to conventional osteotomies on post‐rhinoplasty ecchymosis and oedema . However, the efficacy of piezoelectric osteotomy perioperatively remains controversial …”

Section: Introductionmentioning

confidence: 99%

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Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Kim

Kang

Jin

et al. 2019

Clinical Otolaryngology

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Objectives This study evaluated the efficacy of piezoelectric osteotomy in reducing oedema and ecchymosis during rhinoplasty via a systematic review with meta‐analysis. Design and setting Two authors independently searched the referenced databases. PubMed, Embase, SCOPUS, the Web of Science, the Cochrane library and Google Scholar databases were systematically searched from inception to January 2019. Participants Sufficient data were retrieved for a meta‐analysis of six trials with a total of 327 patients. Main outcome measures They included studies that compared piezoelectric osteotomy (treatment groups) with conventional osteotomy (control group). The outcomes of interest were operative time, mucosal injury, oedema, ecchymosis and postoperative pain. Baseline study characteristics, quality of study, numbers of patients in the treatment and control groups and outcomes were extracted. Results Intraoperative mucosal injury was significantly lower in the treatment group vs the control group, but operative time was longer in the treatment group. Eyelid oedema and ecchymosis in the first seven days postoperatively were statistically decreased in the treatment group vs the control group. In addition, pain in the first three days postoperatively was statistically decreased in the treatment group vs the control group. However, in a subgroup analysis according to osteotomy visibility in the control group (blind osteotomy vs osteotomy under direct vision), there was no significant difference in oedema and ecchymosis between treatment and osteotomy under direct vision. Conclusions Piezoelectric osteotomy during rhinoplasty can reduce eyelid oedema and eyelid ecchymosis compared to conventional osteotomy. However, piezoelectric osteotomy had no significant advantages in terms of postoperative oedema and ecchymosis compared to osteotomy under direct vision.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Kim

Kang

Jin

et al. 2019

Clinical Otolaryngology

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Piezosurgery versus conventional osteotomy in rhinoplasty: A systematic review and meta‐analysis

2019

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Objective: Piezosurgery, used in different otolaryngology procedures, was a breakthrough in surgery. We systematically reviewed the differences in outcomes after lateral nasal osteotomy with peizosurgery and conventional osteotome and quantified the differences through a meta-analysis.Methods: Medline, Embase, and Cochrane library databases were selected to search for randomized clinical trials (RCTs) published before January 2019 that detailed differences between piezosurgery and conventional osteotomy. The key search terms included "rhinoplasty" and "piezosurgery." Only RCTs in English with patients >18 years who underwent lateral osteotomy by percutaneous or internal approaches were included. PRISMA guidelines were followed in data extraction and study inclusion. Two independent reviewers assessed the relevance of the studies. The point of estimate in the meta-analysis was the standardized mean difference and was pooled with the random-effects model. The measured outcomes were ecchymosis, edema, postoperative pain, and duration of surgery.Results: Five RCTs met our criteria and were analyzed in primary subsequent meta-analyses. Piezosurgery demonstrated significantly lower edema (SMD = -0.75; 95% CI, -1.26, -0.24) and ecchymosis scores (SMD = -0.85; 95% CI, -1.49, -0.20) on postoperative days (POD) 2 or 3 than conventional surgery. They were also significantly lower with piezosurgery than conventional surgery on POD 7 (SMD = -0.64; 95% CI, -1.21, -0.06; and SMD = -0.64; 95% CI, -1.14, -0.14, respectively). Two studies that estimated the degree of pain showed that after piezosurgery, patients experienced lesser pain than after conventional surgery. The mean difference was -0.73 (95% CI, -1.06, -0.39).Conclusions: Piezosurgery causes less ecchymosis, edema, and pain than conventional osteotomy, without extending the duration of surgery.

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Method of Lateral Osteotomy to Reduce Eyelid Edema and Ecchymosis After Rhinoplasty: A Meta‐analysis

Kim

Hwang

2020

The Laryngoscope

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Objectives 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. Study Design A literature search using MEDLINE, SCOPUS, and Cochrane databases. Methods 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. Results 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], I2 = 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. Conclusions 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

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Double-Blind Comparison of Ultrasonic and Conventional Osteotomy in Terms of Early Postoperative Edema and Ecchymosis

Abstract: 3 Therapeutic.

Cited by 55 publications

References 31 publications

Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Piezosurgery versus conventional osteotomy in rhinoplasty: A systematic review and meta‐analysis

Method of Lateral Osteotomy to Reduce Eyelid Edema and Ecchymosis After Rhinoplasty: A Meta‐analysis

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