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Piezosurgery in hemifacial microsomia: a promising exemption from conventional peri-osteotomy suffering
Xuetong Wang1, Byeong Seop Kim1, Ziwei Zhang1
1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Introduction:
Mandibular distraction osteogenesis, a recommended therapy for hemifacial microsomia, has brought much agony because of its traumatic procedures and peri-osteotomy complications. Our study aims to retrospectively compare piezoelectric osteotome with conventional reciprocal bone saw for hemifacial microsomia patients and validate its meliority in operability, surgical risks and patient outcomes.
Methods:
All patients included underwent osteotomies conducted by either piezosurgery or bone saw. Information of intraoperative blood loss, operation duration, postoperative pain and complications was collected from patient files, ward round inspections and follow-ups.
Results:
Among all 40 patients, 13 underwent piezo-osteotomy. Piezosurgery performed better than conventional reciprocal bone saw in decreasing intraoperative blood loss (p < 0.001) and operation duration (p = 0.030). No significant difference was found in hospitalization duration, total expenses or complication rates between two groups. There were positive relations between operation duration and intraoperative blood loss (p = 0.042), and between hospitalization duration and total expenses (p = 0.0096). Postoperative pain scores of both groups declined over time while the piezosurgery group had a statistically significant tendency (p = 0.006) to suffer less than the conventional group.
Discussion:
Piezosurgery diminishes intraoperative blood loss, operative duration, and postoperative pain, making an alternative to conventional osteotomes to mitigate patients' and families' peri-osteotomy sufferings, and a more humane solution to HFM.
Insights
Piezosurgery significantly reduces blood loss and operative time in mandibular distraction osteogenesis for hemifacial microsomia. This innovative technique offers a less painful and more humane surgical option for patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Medicine
- Biomedical Engineering
Background:
- Mandibular distraction osteogenesis is crucial for treating hemifacial microsomia but involves traumatic procedures.
- Conventional bone sawing techniques can lead to significant peri-osteotomy complications and patient suffering.
Purpose of the Study:
- To retrospectively compare piezoelectric osteotomy (piezosurgery) with conventional bone saw for mandibular distraction osteogenesis.
- To evaluate differences in operability, surgical risks, and patient outcomes between the two techniques.
Main Methods:
- A retrospective analysis of 40 hemifacial microsomia patients who underwent osteotomies.
- Comparison of data including intraoperative blood loss, operation duration, postoperative pain, and complications between piezosurgery and bone saw groups.
Main Results:
- Piezosurgery demonstrated significantly lower intraoperative blood loss (p < 0.001) and operation duration (p = 0.030) compared to the bone saw.
- The piezosurgery group experienced statistically significant less postoperative pain (p = 0.006).
- No significant differences were observed in hospitalization duration, total expenses, or complication rates.
Conclusions:
- Piezosurgery is a superior alternative to conventional bone saws for mandibular distraction osteogenesis.
- This technique effectively reduces intraoperative bleeding, operative time, and postoperative pain.
- Piezosurgery offers a more humane and less agonizing approach for hemifacial microsomia treatment.
