Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Kim, Do Hyun; Kang, Hyeon Hui; Jin, Ho Jun; Hwang, Se Hwan

doi:10.1111/coa.13415

Cited by 15 publications

(16 citation statements)

References 21 publications

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“…3 Severe pain may occur in the postoperative period of septorhinoplasty due to soft tissue injury and osteotomies. 5 On a numerical rating scale (NRS) 6 from 0 to 10, a pain score of >3 in 45% of patients and a pain score of >6 in almost 30% of patients were reported after a septorhinoplasty operation. 7 In their study examining the postoperative pain of patients undergoing rhinoplasty operation, Demir et al accepted patients with an NRS score of ≥5 as patients with postoperative pain and applied analgesics to them.…”

Section: Introductionmentioning

confidence: 99%

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Kaçar

Uzundere

Salık

et al. 2020

JPR

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In this study, we evaluated the hypothesis that preoperative bilateral infraoptic nerve (ION) and infratrochlear nerve (ITN) blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of emergence agitation (EA), pain scores, and the analgesic consumption after the septorhinoplasty. Patients and Methods: Our study was conducted as a prospective randomized, double-sided blind study. Fifty-two patients whose septorhinoplasty operation was planned under general anesthesia were included in the study. Patients were randomly distributed to either the ION and ITN blocks were performed. Group 1: Bilateral ION and ITN blocks were performed; Group 2: ION and ITN blocks were not performed. Duration of the surgery and anesthesia, Riker Sedation-Agitation Scale (RSAS) score, EA presence, duration of postoperative analgesia, numerical rating scale (NRS) scores, and cumulative dexketoprofen consumption were recorded. Results: The RSAS score, NRS score and cumulative dexketoprofen consumption of the patients in Group 1 were statistically significantly lower than the patients in Group 2 (p<0.05). It was also found that patients in Group 1 (n: 8/26) had less EA compared to patients in Group 2 (n: 16/26) and this difference was statistically significant (p: 0.026). Postoperative analgesia duration of patients in Group 1 was found to be statistically significantly higher than patients in Group 2 (p: <0.001). In addition, the number of patients given postoperative dexketoprofen in Group 1 (n: 8/26) was found to be statistically significantly lower than patients in Group 2 (n: 25/26). (p: <0.001). Conclusion: Bilateral ION and ITN blocks in septorhinoplasty operation is an effective, reliable and simple technique in the treatment of postoperative pain.

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Section: Introductionmentioning

confidence: 99%

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Kaçar

Uzundere

Salık

et al. 2020

JPR

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“…Rhinoplasty is a commonly performed and widely accepted procedure used to improve nasal function and cosmesis. 1 In 2018, rhinoplasty was the third most common cosmetic procedure performed with more than 200,000 cases according to the American Society of Plastic Surgeons. 2 Nasal bone lateral osteotomies are a critical component of open and closed rhinoplasty.…”

Section: Introductionmentioning

confidence: 99%

“…1 Ultimately, performance of lateral osteotomies translates to greater discomfort and longer postoperative recovery periods for the patient. Previous literature describes attempts to minimize these symptoms through various mechanisms, including elevation of the periosteum in the osteotomy path, 8 utilization of the piezoelectric instrument, 1 and application of direct manual pressure intraoperatively immediately following lateral osteotomy. 9 Despite this, there still remains a component of edema and ecchymosis that will occur in any situation in which osteotomies are used.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] The most important cause of periorbital edema and ecchymosis is due to soft tissue damage in the lateral osteotomy region. 1 Ultimately, performance of lateral osteotomies translates to greater discomfort and longer postoperative recovery periods for the patient. Previous literature describes attempts to minimize these symptoms through various mechanisms, including elevation of the periosteum in the osteotomy path, 8 utilization of the piezoelectric instrument, 1 and application of direct manual pressure intraoperatively immediately following lateral osteotomy.…”

Section: Introductionmentioning

confidence: 99%

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Trading Osteoplasty for Osteotomy in an Attempt to Achieve a Rapid Recovery Rhinoplasty

et al. 2021

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Nasal bone lateral osteotomies are a critical component of open and closed rhinoplasty. Lateral osteotomies represent the most traumatic component of rhinoplasty and contribute to significant edema and ecchymosis in the periorbital region. We believe that lateral osteotomies are often performed more frequently than necessary. The senior author of this article has significantly decreased the number of lateral osteotomies that he performs during rhinoplasty and instead advocates for the use of osteoplasty with a rasp when appropriate to narrow and shape the bony dorsum without forming a wide flat open-roof deformity. This study is a retrospective chart review of 239 patients who underwent rhinoplasty with the senior author. Almost half of the patients (44%) did not undergo osteotomies. The revision rate is less than 1% (2 patients). Avoidance of lateral osteotomies in carefully selected patients can offer a more appealing “rapid recovery rhino,” which is characterized by decreased edema, swelling, and faster recovery time with less limitations on postoperative restrictions.

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“…The main cause of edema and ecchymosis after rhinoplasty is soft tissue damage at osteotomy site 2 . A careful and delicate surgical approach could help decrease this damage, but it cannot be completely prevented 3 …”

Section: Introductionmentioning

confidence: 99%

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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Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty

Cited by 15 publications

References 21 publications

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Trading Osteoplasty for Osteotomy in an Attempt to Achieve a Rapid Recovery Rhinoplasty

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

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