Radiological Comparison of Piezosurgery and Classical Osteotomies in Rhinoplasty

The aim of this study is to compare the radiological measurements of patients who underwent rhinoplasty using a piezo device with those of patients who underwent rhinoplasty using a classical osteotome.

A total of 60 patients were included in the study: 30 rhinoplasty patients who underwent piezosurgical osteotomy and 30 who underwent classical osteotomy. Preoperative and postoperative functional and aesthetic outcomes were compared using NOSE and ROE scores. Four anthropometric parameters were measured radiologically before and after surgery: nasofrontal angle (NFA), nasal bone length (NL), pyramidal angle (PA) and the closest distance between the nasolacrimal canal and the rhinoplasty fracture line (N-R). The pyramidal angle (PA) was measured separately at two levels: at the nasal root (PA-R) and at the tip of the nasal bone (PA-T).

The two groups were similar in terms of age, gender, and follow-up period (p > 0.05). The operative time was significantly longer in the Piezo group (p < 0.001). Preoperative and postoperative ROE values, as well as preoperative NOSE values, were comparable between the two groups (p > 0.05). However, postoperative NOSE values were statistically significantly lower in the Piezo group compared to the Osteotome group (p = 0.004). Surgery significantly affected both NOSE and ROE values in each group (p < 0.001). No statistically significant differences were found between the groups in terms of preoperative and postoperative NFA, PA-R, and PA-T values (p > 0.05). Preoperative NL values were also similar between the groups; however, postoperative NL values were significantly shorter in the Piezo group (p < 0.001). A statistically significant difference was observed in both right and left side N-R values between the groups (right: p = 0.025; left: p = 0.010), with the N-R distance being shorter in the Piezo group.

The long-term aesthetic outcomes of the piezosurgery and conventional osteotomy groups were similar; however, the piezosurgery group demonstrated better functional results. The safe margin for the nasolacrimal canal was narrower when osteotomy was performed using piezosurgery. This finding warrants caution regarding potential complications in the lacrimal system.

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