Piezosurgery: Ten-years experience of percutaneous osteotomies in rhinoplasty

Publication date: Available online 31 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Massimo Robiony, Andrea Lazzarotto, Riccardo Nocini, Fabio Costa, Salvatore Sembronio, Leonardo Franz

Abstract

Purpose

The possibility to obtain precise osteotomies without significant soft tissue damage represents a key point in modern approaches to rhinoplasty. In 2007, we first described the ultrasonic approach for percutaneous nasal bone osteotomies with minimal periosteal detachment.

In this article, we retrospectively analyse the results of our piezosurgical rhinoplasty technique through our ten-year experience and describe the new perspectives of this technique.

Patients and Methods

A series of 183 patients was retrospectively evaluated. Surgical technique was based on piezoelectric external nasal osteotomies, performed percutaneously, without periosteal detachment. For the last patients, the piezoelectric instrument was also tracked with navigator (piezo-navigated approach). Data about surgery, hospitalization, ecchymosis, edema, and postoperative complications were evaluated.

Results

168 of the 183 patients (91.8%) showed grade 0 or 1 edema. Grade 2 edema was noticed in only 15 of 183 patients (8.2%). In 6 of the 183 procedures (3.3%), postoperative complications potentially related to the piezoelectric osteotomy system occurred.

Conclusion

Piezoelectric external approach could be considered as a safe and reliable technique. Preliminary data suggest the possibility of using surgical planning and navigation in positioning the osteotomies in selected subsets of patients.

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