Piezotome-Rhinoplasty reduces post-surgical morbidity and enhances patient satisfaction: a multidisciplinary clinical study

Publication date: Available online 23 April 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Troedhan Angelo
PurposeExperimental and clinical studies in various fields of oral and maxillofacial surgery suggest the use of piezotomes to reduce post-surgical morbidity and enhance healing. The aim of the study was to investigate if rhinoplasty-surgery with piezotomes might decrease post-surgical morbidity and increase overall patient satisfaction when compared to rhinoplasty with traditional instruments and protocols.MethodsIn this prospective clinical study patients of the departments for cosmetic surgery, ENT and specialty-ambulance for maxillofacial surgery, scheduled for cosmetic reductive rhinoplasty, underwent rhinoplasty with traditional instruments or the ultrasonic surgical device "piezotome". Before rhinoplasty all patients were evaluated by Rhinoplasty Outcome Evaluation (ROE), staged for ecchymosis and edema (EE) and pain (D) on the 7^th day after surgery and six months after surgery again evaluated by ROE-score. Female and male patients were aged between 24 and 57yrs and had to be free of functional impairments of nose-breathing. Data were anonymized and evaluated with SPSS 22.0 (one-way ANOVA, Games-Howell post-hoc-test for primary and secondary outcome evaluation, Leven-Test of equal variances, t-test and Pearson-Correlation of primary and secondary outcome evaluation).Results108 patients (51 females and 12 males) were fully documented by EE/D-staging and ROE and underwent cosmetic rhinoplasty at a department of plastic and reconstructive surgery, an ENT-department, and a specialty ambulance for maxillofacial surgery. 16 female and 5 male patients –fully documented - received a piezotome-rhinoplasty. Statistic evaluation verified no significant differences between the three surgical disciplines when a rhinoplasty was performed with traditional instruments (p>0,7), but demonstrated the use of ultrasonic surgical instruments to improve immediate post-surgical morbidity EE and D significantly (P<0,05) as well as ROE after 6 months (P<0,05). Correlation of EE and D with ROE showed a significant difference (P≤0,01) in favor of the piezotome.ConclusionThe use of ultrasonic surgical devices in reductive rhinoplasty decreases post-surgical morbidity and increase patient overall satisfaction significantly. The results of the study suggest piezotomes to be the surgical instrument of choice not only for oral surgical procedures but also for cosmetic surgery on facial bones.

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