Is Piezosurgery Associated with Improved Patient Outcomes Compared to Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of RCTs
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Population
2.2. Literature Search
2.3. Selection Criteria
2.4. Outcomes Measures
2.5. Study Selection
2.6. Data Curation
2.7. Methodological Quality Assessment
2.8. Data Synthesis and Analysis
3. Results
3.1. Literature Search and Screening Results
3.2. Baseline Characteristics of Included Studies
3.3. Methodological Quality
3.4. Postoperative Edema
3.4.1. Degree of Edema
3.4.2. Risk of Edema
3.4.3. Impact of Surgical Approach
3.4.4. Impact of Edema Grade
3.5. Postoperative Ecchymosis
3.5.1. Degree of Ecchymosis
3.5.2. Risk of Ecchymosis
3.5.3. Impact of Surgical Approach
3.5.4. Impact of Ecchymosis Grade
3.6. Complications
3.6.1. Overall Complications
3.6.2. Postoperative Hemorrhage
3.6.3. Mucosal Injury
3.7. Postoperative Pain (VAS Score)
3.7.1. Pain Score
3.7.2. Pain Requiring Analgesia (VAS > 3)
3.7.3. Impact of Surgical Approach
3.8. Operative Time (Hours)
4. Discussion
Strengths, Limitations, and Future Research Directions
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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SR/MA | Date of Search | Sample | ROB | Ecchymosis | Edema | Pain | ||
---|---|---|---|---|---|---|---|---|
Tsikopoulos et a ORL | 2019 | 5 RCTs | 4 low; 3 unclear | POD 3: POD 7: | ↓(4 RCTs) ↓(4 RCTs) | POD 3; POD 7: | ↓(4 RCTs) ↓(4 RCTs) | POD 3: ↓(2RCTs) |
Mirza et al. The Laryngoscope | 2019 | 6 RCTs | 7 high | POD (2/3) POD 7: | ↓(5 RCTs) ↓(5 RCTs) | POD 3/4 POD 7: | ↓(5 RCTS) ↓(5 RCTS) | POD 2: ↓(2RCTB) |
Khajuria et al. PRS Global Open | 2022 | 9 RCTs | 4 high; 5 unclear | POD 2: POD 3: POD 4: POD 7: | ↓(2 RCTs) ↓(2 RCTs) ↓(1 RCT) ↓(4 RCTS) | POD 2: POD 3: POD 4: POD 7: | ↓(2 RCIs) ↓(2 RCTs) Ns(1 RCT) ↓(4 RCTs) | POD 1: ↓(1 RCT) POD 2:↓(2 RCTs) POD 3:↓(1 RCT) POD 7:↓(1 RCT) |
Author (YOP) | Country | Design | Sample (OS) | Gender (Male) | Age Mean (SD) | Internal Approach | External Approach | Osteotomy Type | Instrument | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PZ | CO | PZ | CO | PZ | CO | PZ | CO | PZ | CO | PZ | CO | Type | PZ | CO | |||
Aydoğdu (2020) [16] | Turkey | RCT | 36 | 36 | Both = 30 | Both = 28.1 (6.5) | 0 | 0 | 36 | 36 | 36 | 36 | Lateral | Woodpecker piezosurgery unit SDT-E702 | A 2 mm-wide chisel | ||
Demirbilek (2019) [18] | Turkey | RCT | 15 | 15 | 6 | 3 | 28.46 (8.08) | 29.86 (8.47) | - | - | - | - | 15 | 15 | Lateral and median | Woodpecker piezosurgery unit SDT-E702 | 4 mm sharp osteotomes |
Fallahi (2019) [7] | Iran | RCT | 10 | 10 | 4 | 4 | 24.9 (2.38) | 24 (1.63) | 10 | 10 | 0 | 0 | 10 | 10 | Lateral | Principal micro-saw OT7 | Double-guarded straight osteotome |
Ghavimi (2018) [19] | Iran | RCT | 33 | 33 | 17 | 28 | - | - | - | 0 | - | 33 | 33 | 33 | Lateral | Viosurg device from NSK Company with a lateral osteotomy pen | 2-mm osteotome |
Koc (2017) [8] | Turkey | RCT | 32 | 33 | Both = 29 | 23.6 (5.71) | 24.1 (5.72) | - | - | - | 33 | 32 | 33 | Lateral | Piezosurgery Flex medical device | - | |
Koçak (2017) [5] | Turkey | RCT | 24 | 25 | Both = 17 | 28.5 (3) | 25.7 (5.4) | 24 | 25 | 0 | 0 | 13–11 | 9–16 | Transverse with low-to-low lateral—low-to-high lateral | NSK VarioSurg 3 device tips | 3 mm guided curved osteotome | |
Malekpour Ghorbani (2023) [20] | Iran | RCT | 15 | 15 | 7 | Both = 26.6 (5.72) | - | - | - | - | 15 | 15 | Lateral | Piezo scalpel OT7S-3 | - | ||
Taşkın (2017) [21] | Turkey | RCT | 45 | 45 | 34 | Both = 25.6 (5.6) | - | - | - | - | 45 | 45 | Median-oblique and lateral | VarioSurg 3 piezosurgery unit | 2 mm guarded, straight osteotome | ||
Tirelli (2015) [22] | Italy | RCT | 10 | 12 | 10 | - | - | 0 | 0 | 10 | 12 | 10 | 12 | Lateral | MT1S-10 tip of the PMD | 2-mm wide osteotome | |
Hashemi (2023) [17] | USA | RCT | 31 | 31 | 7 | Both = 28.43 (7.77) | - | - | - | - | 31 | Lateral (low-to-low) | The Mectron Piezosurgery | Straight guarded osteotome | |||
Troedhan (2016) [23] | Austria | RCT | 21 | 63 | - | - | Both = 44 (11) | - | - | - | - | - | - | - | Piezotome I or II | Chisels and rasps | |
Shafik (2023) [14] | Egypt | RCT | 20 | 20 | 6 | 4 | Both = 33.34 (10.23) | - | - | - | - | - | - | Lateral and medial | Piezo medical device with an MT-1 insert tip from | - |
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Safia, A.; Abd Elhadi, U.; Farhat, R.; Elgrinawi, S.; Safieh, J.; Bader, R.; Khater, A.; Merchavy, S.; Massoud, S. Is Piezosurgery Associated with Improved Patient Outcomes Compared to Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of RCTs. J. Clin. Med. 2024, 13, 3635. https://doi.org/10.3390/jcm13133635
Safia A, Abd Elhadi U, Farhat R, Elgrinawi S, Safieh J, Bader R, Khater A, Merchavy S, Massoud S. Is Piezosurgery Associated with Improved Patient Outcomes Compared to Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of RCTs. Journal of Clinical Medicine. 2024; 13(13):3635. https://doi.org/10.3390/jcm13133635
Chicago/Turabian StyleSafia, Alaa, Uday Abd Elhadi, Raed Farhat, Salman Elgrinawi, Jawad Safieh, Rawnk Bader, Ashraf Khater, Shlomo Merchavy, and Saqr Massoud. 2024. "Is Piezosurgery Associated with Improved Patient Outcomes Compared to Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of RCTs" Journal of Clinical Medicine 13, no. 13: 3635. https://doi.org/10.3390/jcm13133635
APA StyleSafia, A., Abd Elhadi, U., Farhat, R., Elgrinawi, S., Safieh, J., Bader, R., Khater, A., Merchavy, S., & Massoud, S. (2024). Is Piezosurgery Associated with Improved Patient Outcomes Compared to Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of RCTs. Journal of Clinical Medicine, 13(13), 3635. https://doi.org/10.3390/jcm13133635