Comparing the piezoelectric and conventional osteotome in rhinoplasty

Importance: Edema affects outcomes in Rhinoplasty. Edema and bruising influences patient satisfaction in the perioperative period. Objective: A qualitative analysis of edema comparing piezoelectric and conventional osteotome, and a qualitative comparison of bruising between these methods.Design: A prospective cohort study of 31 aesthetic Rhinoplasty cases. Participants act as their own control measure. An osteotome is used on one side of the nasal bone and a piezoelectric is used contralaterally. Main outcomes and measures: Edema is calculated by comparing a pre and post-operative 3-D image with volu-metric analysis. Ecchymosis is scored and compared.Results: The mean volume of the piezoelectric was 1.37 cc (SD 0.87) and the mean volume of the osteotome was 1.17 cc (SD 0.70) (0.19 absolute difference [95 % CI 0.3 to 0.35], p = 0.02). Bruising scores were 0.35 points lower for the piezoelectric arm (-0.35 absolute difference [95%CI-0.7 to 0.06], p < 0.01). This corresponded to 26 % of lateral piezo osteotomies having significant bruising compared to 38 % of the lateral osteotomies using the conventional technique. Conclusion: There is a difference in postoperative edema and bruising with the piezoelectric and conventional osteotome for lateral osteoetomy in Rhinoplasty. There is more edema with the piezoelectric and more ecchy-mosis with the conventional osteotome.