Abstract:
Background: Rhinoplasty is a common plastic surgery procedure with evolving surgical techniques. This systematic review and meta-analysis compares the outcomes of piezosurgery versus conventional osteotomy in rhinoplasty. Methods: A comprehensive search of six databases yielded 12 randomized controlled trials (RCTs) comparing piezosurgery (292 cases) to conventional osteotomy (338 cases) in rhinoplasty patients. The examined outcomes included postoperative edema, ecchymosis, complications, pain (using the Visual Analogue Scale-VAS), and operative time. Subgroup analyses were conducted based on the assessment timepoint, surgical approach, and outcome grade. The risk of bias was evaluated using the revised Cochrane tool. Results: Piezosurgery showed a significant reduction in the degree of postoperative edema (second and seventh postoperative days) and ecchymosis (second, fourth, and seventh postoperative days). The external approach in piezosurgery demonstrated greater benefits for both outcomes. Piezosurgery was associated with a significant reduction in overall complications, especially mucosal injuries, compared to conventional osteotomy, with no significant difference regarding postoperative hemorrhage. A significant reduction in pain scores and the need for analgesia was observed with piezosurgery. No significant difference was found in operative time. Conclusions: Piezosurgery offers significant benefits in patient outcomes, with similar operative time between both techniques. However, long-term investigations are still needed.
摘要:
背景:鼻成形术是一种常见的整形外科手术,其外科技术不断发展。这项系统评价和荟萃分析比较了压电手术与传统截骨术在隆鼻手术中的效果。方法:对六个数据库进行全面搜索,得出12项随机对照试验(RCT),比较了鼻整形患者的压电手术(292例)和常规截骨术(338例)。检查结果包括术后水肿,瘀斑,并发症,疼痛(使用视觉模拟量表-VAS),和手术时间。根据评估时间点进行亚组分析,手术方法,和结果等级。使用修订后的Cochrane工具评估偏倚风险。结果:压电手术显示术后水肿程度(术后第2天和第7天)和瘀斑程度(第二,第四,和术后第七天)。压电手术的外部方法对两种结果均具有更大的益处。压电手术与整体并发症的显著减少有关,尤其是粘膜损伤,与传统截骨相比,术后出血无显著差异。使用压电手术观察到疼痛评分显着降低,并且需要镇痛。手术时间差异无统计学意义。结论:压电手术在患者预后方面具有显着的优势,两种技术之间的手术时间相似。然而,仍然需要长期调查。