The Impact of Osteotomies in Rhinoplasty on Systemic Inflammation and Early Postoperative Quality of Life

This study evaluated early postoperative systemic inflammation, periorbital ecchymosis, edema, and quality of life in patients undergoing rhinoplasty with conventional osteotomy, piezoelectric osteotomy, or no osteotomy.

This prospective study included 175 patients divided into 3 groups: group 1 (n=80), conventional osteotomy; group 2 (n=63), piezoelectric osteotomy; and group 3 (n=32), no osteotomy. Preoperative and postoperative day 1 blood samples were analyzed for neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory marker (SIM), hemoglobin (Hb), CRP, ESR, and albumin. Postoperative evaluation included edema, ecchymosis scores, and the Quality of Recovery-15 (QoR-15) questionnaire.

Neutrophil-to-lymphocyte ratio increase and Hb decrease were significant in groups 1 and 2 compared with group 3, whereas SII increase was significantly higher in group 2 than in group 3. No differences were found between groups 1 and 2 for these parameters. Edema and ecchymosis were significantly lower in group 3, with ecchymosis also lower in group 2 compared with group 1, but no differences in edema were observed between groups 1 and 2. QoR-15 scores were significantly higher in group 3 than in groups 1 and 2, with no differences between groups 1 and 2.

The no-osteotomy group showed better outcomes in inflammation, edema, ecchymosis, and QoR-15 scores, suggesting that increased inflammation is linked to osteotomy rather than the technique used. While ecchymosis differed between conventional osteotomy and piezosurgery, this did not impact inflammation or quality of life.