Piezoelectric technology in otolaryngology, and head and neck surgery: a review

Meller, Catherine; Havas, Thomas

doi:10.1017/s0022215117000767

Cited by 35 publications

(34 citation statements)

References 58 publications

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“…15 Second, the piezosurgery device is very expensive, and ultrasonic tips have additional costs. 22 The tips could be used for more than one patient as osteotomes. Additionally, reduced postoperative morbidities and more precise osteotomies could decrease additional expenses related to postoperative care or revision surgery.…”

Section: Summary Of Main Resultsmentioning

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: Summary Of Main Resultsmentioning

confidence: 99%

“…This problem may decrease as surgeons become familiar with its use, and inconvenience of the learning curve would be offset by comfort and satisfaction for patients and surgeons . Second, the piezosurgery device is very expensive, and ultrasonic tips have additional costs . The tips could be used for more than one patient as osteotomes.…”

Section: Discussionmentioning

confidence: 99%

Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Kim

Kang

Jin

et al. 2019

Clinical Otolaryngology

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“…This finding suggests that as the learning curves of the practicing surgeons grow, the difference in the duration of surgery between the two techniques would become less significant. Additional disadvantages of the piezosurgery technique included cost and economic feasibility …”

Section: Discussionmentioning

confidence: 99%

“…This results in the rate of bleeding, ecchymosis, edema, and subsequent pain being relatively less. However, its main disadvantages include the high cost and the extended operating time . Several trials have been conducted to evaluate its utility and safety .…”

Section: Introductionmentioning

confidence: 99%

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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“…The review from Meller and Havas is a great example of how to avoid a narrative review, and produce a quality review that is both comprehensive and unbiased. 4 The work follows the theme of compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ('PRISMA'), 5 which is used as a template for their systematic review. The Journal is always very open to such quality review work.…”

mentioning

confidence: 99%

Centralised databases as a primer for research

Harvey¹

2017

J. Laryngol. Otol.

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Piezoelectric technology in otolaryngology, and head and neck surgery: a review

Cited by 35 publications

References 58 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

Centralised databases as a primer for research

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