PDF(Pubmed)
Abstract：
The piezo surgery was reported to cause minimal trauma to the soft tissue. The aim of this study was to compare the periorbital edema and ecchymosis after transcutaneous lateral osteotomy in rhinoplasty using 2-mm osteotome versus Piezo scalpel respectively. In a randomized clinical trial and split-mouth-design, we performed primary rhinoplasty in 15 patients (7 men, 8 women; age 18-35 years, mean age 26.6 ± 5.7 years). Transcutaneous lateral osteotomy was performed using a 2-mm osteotome on the one side and a piezo scalpel on the opposite side. We took digital photographs of the face on 1, 3, 7 and 14 postoperative days. Three examiners used a standard 5-point Kara-Gokalan scale to assess the early postoperative periorbital edema and ecchymosis on each side. We found more difficult to use the piezo scalpel via only one incision and found easier to use two stab incisions for inserting the piezo scalpel. The time spend for each osteotomy was similar (P > 0.05). The inter-observer agreement was high (> 0.676). The postoperative edema showed to be significantly different on day 1, 3 and 7 (P-value < 0.05), ecchymosis was much less on piezo side but not significantly. It was more difficult to use piezo scalpel via only one incision. The piezo scalpel showed to reduce the postoperative edema significantly and improved the ecchymosis. Swelling and bleeding could have crossed the midline and blurred the comparison of two sides. However, this is the best design to achieve the highest similarity in study condition. Level of Evidence Level I, therapeutic study.
摘要：
据报道，压电手术对软组织造成的创伤很小。这项研究的目的是比较分别使用2毫米骨凿和压电手术刀在鼻成形术中经皮外侧截骨术后的眶周水肿和瘀斑。在一项随机临床试验和裂口设计中，我们对15例患者(7例男性，8名女性；年龄18-35岁，平均年龄26.6±5.7岁)。一侧使用2毫米骨凿，另一侧使用压电手术刀进行经皮外侧截骨术。我们在术后1、3、7和14天拍摄了面部数码照片。三名检查者使用标准的5点Kara-Gokalan量表评估两侧的早期术后眶周水肿和瘀斑。我们发现仅通过一个切口使用压电手术刀更加困难，并且发现更容易使用两个穿刺切口插入压电手术刀。每次截骨时间相似(P>0.05)。观察员之间的协议很高（>0.676）。术后第1、3、7天水肿差异有统计学意义(P<0.05),压电侧瘀斑少得多，但不明显。仅通过一个切口使用压电手术刀更加困难。压电手术刀显示明显减轻术后水肿，改善瘀斑。肿胀和出血可能越过中线，模糊了双方的比较。然而,这是在研究条件下达到最高相似度的最佳设计。一级证据,治疗性研究。
