The Use of Conical Powered Burrs in Surgery of the Bony Nasal Pyramid

Background: Rhinoseptoplasty is regarded by many surgeons as one of the most demanding procedures in aesthetic surgery. The introduction of new surgical techniques and instruments aims to improve treatment outcomes, increase procedural safety and reproducibility, reduce soft-tissue trauma and shorten operative time. The development of powered instrumentation has contributed substantially to progress in nasal surgery by supporting these goals. The aim of this study was to compare the aesthetic and functional outcomes of rhinoseptoplasty performed with powered instrumentation (PI) and with conventional methods (CR). Methods: The study included 106 patients (78 women, 28 men) aged 18-65 years (mean 34 ± 9.8) who were qualified for surgery. CR were used in 62 (58.5%), while PI were used in 44 (41.5%). Patients completed the Rhinoplasty Outcome Evaluation (ROE) and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaires before surgery and 6 months postoperatively. The data were statistically analyzed. Results: Both groups demonstrated statistically significant postoperative improvement in all assessed questionnaire outcomes (p < 0.0001). ROE scores increased, whereas total SCHNOS, SCHNOS-O, and SCHNOS-C scores decreased. Effect-size analysis indicated a stronger therapeutic effect in the PI group than in the CR group: ROE Cohen's d, 3.48 vs. 3.07; total SCHNOS r, 0.99 vs. 0.80; SCHNOS-O r, 0.85 vs. 0.62; and SCHNOS-C r, 0.97 vs. 0.93. No major intraoperative complications were observed. Conclusions: Meaningful gains in patient-reported outcomes were observed following rhinoseptoplasty in this cohort. The findings provide a rationale for future studies examining whether powered instrumentation offers measurable advantages in selected patients and surgical contexts.