Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty.

[OBJECTIVES] This study evaluated the efficacy of piezoelectric osteotomy in reducing oedema and ecchymosis during rhinoplasty via a systematic review with meta-analysis.

[DESIGN AND SETTING] Two authors independently searched the referenced databases. PubMed, Embase, SCOPUS, the Web of Science, the Cochrane library and Google Scholar databases were systematically searched from inception to January 2019.

[PARTICIPANTS] Sufficient data were retrieved for a meta-analysis of six trials with a total of 327 patients.

[MAIN OUTCOME MEASURES] They included studies that compared piezoelectric osteotomy (treatment groups) with conventional osteotomy (control group). The outcomes of interest were operative time, mucosal injury, oedema, ecchymosis and postoperative pain. Baseline study characteristics, quality of study, numbers of patients in the treatment and control groups and outcomes were extracted.

[RESULTS] Intraoperative mucosal injury was significantly lower in the treatment group vs the control group, but operative time was longer in the treatment group. Eyelid oedema and ecchymosis in the first seven days postoperatively were statistically decreased in the treatment group vs the control group. In addition, pain in the first three days postoperatively was statistically decreased in the treatment group vs the control group. However, in a subgroup analysis according to osteotomy visibility in the control group (blind osteotomy vs osteotomy under direct vision), there was no significant difference in oedema and ecchymosis between treatment and osteotomy under direct vision.

[CONCLUSIONS] Piezoelectric osteotomy during rhinoplasty can reduce eyelid oedema and eyelid ecchymosis compared to conventional osteotomy. However, piezoelectric osteotomy had no significant advantages in terms of postoperative oedema and ecchymosis compared to osteotomy under direct vision.