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Methods of Lateral Osteotomy in Rhinoplasty: An Updated Systematic Review and Meta-Analysis of Randomised Controlled
Ebraheem Albazee1,2, Ayman Khatib3, Abdulrahman Makhseed4
1Otorhinolaryngology-Head and Neck Surgery, Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait.
Summary
This review found no significant differences in eyelid edema or ecchymosis between external and internal lateral osteotomy techniques in rhinoplasty. However, the external technique showed a higher mean score for step-off deformity.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Evidence-Based Medicine
Background:
- Rhinoplasty commonly involves lateral osteotomy to narrow the nasal bones.
- External and internal osteotomy techniques are utilized, with differing potential outcomes.
- A systematic review and meta-analysis is needed to compare their postoperative results.
Purpose of the Study:
- To conduct an updated systematic review and meta-analysis of randomized controlled trials (RCTs).
- To compare postoperative outcomes of external versus internal lateral osteotomy in rhinoplasty.
- To evaluate eyelid edema, ecchymosis, and step-off deformity.
Main Methods:
- Comprehensive literature search of major databases up to January 2025.
- Included 13 RCTs with 1008 patients; assessed risk of bias using Cochrane's tool.
- Pooled data using standardized mean differences (SMD) and risk ratios (RR) with 95% confidence intervals (CIs).
Main Results:
- No significant differences in eyelid edema or ecchymosis between external and internal osteotomy groups at 2, 3, and 7 days post-surgery.
- The mean score for step-off deformity was significantly higher with the external osteotomy technique (SMD = 0.54, 95% CI [0.19, 0.89]).
- No significant difference in the rate of step-off deformity was observed between the groups (RR = 0.79, 95% CI [0.43, 1.44]).
Conclusions:
- Postoperative eyelid edema, ecchymosis, and the rate of step-off deformity are comparable between external and internal lateral osteotomy in rhinoplasty.
- The external osteotomy technique may be associated with a higher mean score of step-off deformity.
- This meta-analysis provides evidence for comparable functional and aesthetic outcomes regarding specific complications.
