Vergleich von piezoelektrisch assistierter und konventioneller Osteotomie bei der Rhinoplastik

Wähmann, M; Riedel, Frank; Kovačević, Miće; Hopf, A; Albers, Andreas E.

doi:10.1007/s00106-018-0606-2

Cited by 9 publications

(4 citation statements)

References 36 publications

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“…In cases of ecchymosis, piezo surgery is significantly superior to conventional osteotomy in the complete follow-up interval. This could also be confirmed in a systematic literature analysis performed by Währmann et al in 2019 [120]. However, it remains unclear if the relatively minor pains that were described were really alleviated or if this was only a consequence of the patientsʼ impression of decreased ecchymosis.…”

Section: Quality Of External And/or Cosmetic Resultsmentioning

confidence: 64%

Welche Qualität macht den Unterschied?

Dacho

2020

Laryngo-Rhino-Otol

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ZusAmmenfAssungIn kaum einem anderen Bereich ist das Ergebnis so offensichtlich, wie bei der plastisch-ästhetischen Nasenchirurgie. Umsomehr spielen sowohl die Qualität des Eingriffs und im Bereich der Ästhetik die Qualität des Ergebnisses eine herausragende Rolle. Hierbei sind die Erwartungen und der Anspruch des Operateurs nicht immer deckungsgleich mit der des Patienten. Des Weiteren haben Kostenträger, im Falle von Kombinationsoperationen, einen eigenen Fokus zum Thema Qualität, der häufig mit Wirtschaftlichkeit verwechselt wird. Objektive Kriterien spielen für den Arzt eine wesentliche Rolle, wobei für die Patienten sehr häufig weiche Kriterien von wesentlicher Bedeutung sind. Dies ist umso diffiziler, da Schönheit im Auge des Betrachters liegt und mit funktionellen Kriterien, wie Atmung und Riechen vereinbar sein müssen. In der Vielzahl von Qualitätskriterien fällt es dem Laien schwer die richtige Arztwahl zu treffen, insbesondere angesichts unzähliger Siegel, Zertifkate und des Einflusses des Internets bzw. von Social Media. Aber auch der Chirurg muss aus einer Vielzahl von Kongressen, Kursen und Symposien herausfinden, welche dieser Veranstaltungen eine bestimmte Mindestqualität garantiert. Trotz einer enormen Veränderung und Verfeinerung der rhinochirurgischen OP-Techniken im Rahmen der letzten Jahrzehnte, wird die Ergebnisqualität seitens der Patienten konstant vor die Prozedurqualität gestellt. Dieses Referat versucht eine Standortbestimmung möglichst objektivierbarer Qualitätsindikatoren in Kombination mit unterschiedlichen Anforderungen und Standpunkten zum Thema Qualität -aus Sicht des Arztes, des Patienten und des Kostenträgers -zu beleuchten und diese im Spiegel sich verändernder OP-Techniken der plastisch-ästhetischen Nasenchirurgie zu betrachten. AbstrActIn hardly any other field outcome is more obvious as in plasticaesthetic nasal surgery. Both the quality of the procedure and the quality of the result play an outstanding role in the arena of aesthetics. Expectations and interests of the surgeon are not always congruent with those of the patient. Furthermore, payers, in the case of combination surgery, have their own focus on quality, which is often confused with economy. Objective criteria play an essential role for the physician, with soft criteria being very important for patients. This is much more difficult because beauty is in the eye of the beholder and must be compatible with functional conditions such as breathing and smelling. In the variety of quality standards, it is difficult to make the right choice of surgeon for the non-professional, especially in the face of countless seals, certificates and the influence of the internet and social media. But even the surgeon has to ascertain a minimum level of quality from a large number of congresses, courses, and symposia. Despite a tremendous change and refinement of the rhinosurgical techniques over the past decades, quality of the outcome is constantly being prioritized for process quality by the patients. This paper attempts to define mo...

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Section: Quality Of External And/or Cosmetic Resultsmentioning

confidence: 64%

Welche Qualität macht den Unterschied?

Dacho

2020

Laryngo-Rhino-Otol

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“…However, there will be also surgeons who feel an open approach with full degloving combined with the piezo technique will result in less pronounced ecchymosis and edema. 20 As surgical techniques are comprised of many nuances and subtle variations, it is almost impossible to compare the different surgical approaches. Additionally, a lot of surgeons use both approaches and suggest the same postoperative side effects are noted.…”

Section: Discussionmentioning

confidence: 99%

Reducing Postoperative Swelling, Edema, and Ecchymosis after Open Rhinoplasty Using Intranasal Drainage

et al. 2023

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Reducing postoperative strain on the patient after rhinoplasty is an important goal for the surgeon. Many strategies are described to reach that goal. One strategy is to remove blood from under the dissected soft tissue envelope by drains, before it can infiltrate the different layers causing ecchymosis, edema, and swelling. In our setting with wide degloving and using drains, we could show a significant reduction in ecchymosis on day 2 and 14 after surgery (p = 0.006 and p = 0.017). We also observed a significant effect for edema and general swelling on day 2 (p = 0.027 and p = 0.004), but this effect did not reach significance for these two parameters on day 14. And although the long-term effect needs to be assessed in the future, we found that using drains in open rhinoplasty with wide degloving is an easily applicable, cheap, and reproducible approach to reduce postoperative ecchymosis, edema, and swelling.

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“…Piezo bone remodeling and osteotomies dominated publications and scientific programs for a period. [5][6][7] The promotion of long-established push down and let down techniques under the term "Preservation Rhinoplasty" by Saban initiated another significant change to established practice in rhinoplasty. Dorsal reduction techniques shifted from cap osteotomies and component/composite hump reduction to variations in dorsal push and let down techniques.…”

Section: Historical Backgroundmentioning

confidence: 99%

The Limits of Evidence in Rhinoplasty

Gassner

Ordóñez²,

Nunes³

2023

Facial Plast Surg

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The broad trend toward minimally invasive methods in most surgical fields is contrasted by rhinoplasty: Extended open approaches, an increasing number of grafting techniques, donor site depletion, and extensive osteotomies seem to indicate a trend away from minimally invasive methodology for this particular procedure. This article intends to analyze which factors are involved in this and related developments in rhinoplasty.Evidence-based methodology sets the standards for scientific analysis. For rhinoplasty, however, limitations of established scientific methodology are identified. These include the relative lack of objective outcome measures and the impact of various systematic biases on reported results. These biases include operator dependence, interdependence of techniques, biased selection of outcome parameters, and orthodox treatment bias. Upon critical review, the importance of systematic biases may outweigh the impact of evidence-based study in rhinoplasty. Results should therefore be interpreted with caution. Strategies are suggested to identify and mitigate the impact of biases and to improve reporting and outcome analyses in rhinoplasty.

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Vergleich von piezoelektrisch assistierter und konventioneller Osteotomie bei der Rhinoplastik

Cited by 9 publications

References 36 publications

Welche Qualität macht den Unterschied?

Welche Qualität macht den Unterschied?

Reducing Postoperative Swelling, Edema, and Ecchymosis after Open Rhinoplasty Using Intranasal Drainage

The Limits of Evidence in Rhinoplasty

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