Piezoelectric Versus Conventional Rhinoplasty: A GRADE-Assessed Systematic Review and Meta-analysis of Randomized...

Area of Science:

• Plastic Surgery
• Otolaryngology
• Biomedical Engineering

Background:

• Conventional osteotomy in rhinoplasty can lead to significant postoperative morbidity.
• The time-based effects and safety profile of piezoelectric osteotomy versus conventional methods require clarification.

Purpose of the Study:

• To evaluate the time-based effectiveness and safety of piezoelectric osteotomy compared to conventional osteotomy in rhinoplasty.
• To synthesize current evidence on outcomes such as edema, ecchymosis, pain, and mucosal integrity.

Main Methods:

• A systematic review and random-effects meta-analysis of randomized controlled trials were conducted.
• Searched major databases and trial registries up to December 1, 2025, adhering to PRISMA guidelines.
• Nineteen studies (905 patients) were included, with 15 pooled for analysis using ROB-2 and GRADE assessments.

Main Results:

• Piezoelectric osteotomy showed significantly reduced edema at postoperative days 2 and 7, and decreased ecchymosis at days 1, 2, and 7.
• Lower pain scores were observed at postoperative day 2 with piezoelectric use.
• Mucosal integrity loss was significantly less frequent in the piezoelectric group (RR 0.09).

Conclusions:

• Piezoelectric osteotomy offers improved early postoperative outcomes in rhinoplasty, including reduced swelling, bruising, and pain.
• The technique demonstrates superior safety regarding mucosal integrity compared to conventional osteotomy.
• While early benefits are evident, the impact on operative duration requires further investigation.