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ORL; Journal For Oto-rhino-laryngology... 2020Osteotomy of nasal bones in rhinoplasty is associated with postsurgical morbidities. Recent evidence has suggested that a surgical method applying piezoelectric... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Osteotomy of nasal bones in rhinoplasty is associated with postsurgical morbidities. Recent evidence has suggested that a surgical method applying piezoelectric ultrasound waves for nasal osteotomies in rhinoplasty reduces soft tissue damage and causes less postsurgical morbidities compared to conventional methods. The purpose of this study is to compare clinical outcomes of piezoelectric and conventional lateral nasal osteotomies in rhinoplasty.
METHODS
We searched PubMed, CENTRAL, and Web of Science up to 17 August 2019 for studies comparing postoperative outcomes of piezoelectric and conventional lateral osteotomies in rhinoplasty. We included studies comparing results of patients subjected to piezoelectric or conventional lateral nasal osteotomies in rhinoplasty. For outcomes, we considered postoperative pain, eyelid edema, periorbital ecchymosis, and intraoperative mucosal injury.
RESULTS
For eyelid edema, a statistically significant difference in favor of piezoelectric osteotomy was documented within the first 3 postoperative days (standardized mean difference [SMD] = -0.65; 95% CI = -1.18, -0.12, p = 0.02; I2 = 69%) and on postoperative day 7 (SMD = -0.69; 95% CI = -1.47, -0.09; p = 0.08; I2 = 85%). This was also the case for periorbital ecchymosis within the first 3 postoperative days (SMD = -0.85; 95% CI = -1.42, -0.28; p = 0.004; I2 = 72%) and on postoperative day 7 (SMD = -0.52; 95% CI = -0.79, -0.24; p = 0.0003; I2 = 71%). Intraoperative mucosal injury (OR = 0.06; 95% CI = 0.01, 0.53; p = 0.01; Ι2 = 0%) and postoperative pain (SMD = -0.99; 95% CI = -1.78, -0.11; p = 0.01; I2 = 49%) were also statistically lower during piezoelectric osteotomies.
CONCLUSIONS
This study shows that lateral piezoelectric osteotomy in rhinoplasty decreases postoperative pain, edema, ecchymosis, and intraoperative mucosa injuries compared to the conventional osteotomy technique with a chisel. Piezoelectric osteotomies are especially associated with less postoperative edema and ecchymosis in osteotomies not executed under direct vision.
Topics: Ecchymosis; Edema; Humans; Nasal Bone; Osteotomy; Piezosurgery; Postoperative Complications; Rhinoplasty; Treatment Outcome
PubMed: 32320977
DOI: 10.1159/000506707 -
Aesthetic Surgery Journal Feb 2020To deliver a natural, aesthetically pleasing periorbital rejuvenation, restoration of the youthful lid-cheek junction and malar eminence is often essential. However, the...
To deliver a natural, aesthetically pleasing periorbital rejuvenation, restoration of the youthful lid-cheek junction and malar eminence is often essential. However, the management of malar bags is complex secondary to the diverse pathophysiology and varying severity of malar edema, mounds, and festoons. Treatment must be individualized based on extent and content. This scoping review updates the audience on the anatomy, pathophysiology, and evaluation of malar bags in addition to the latest literature regarding minimally invasive intervention and surgical refinements. A modernized treatment algorithm is proposed.
Topics: Blepharoplasty; Cheek; Edema; Humans; Rejuvenation; Rhytidoplasty
PubMed: 31051517
DOI: 10.1093/asj/sjz137