M San Nicoló1, A Berghaus2. 1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland. Marion.Sannicolo@med.uni-muenchen.de. 2. Privatpraxis am Maximiliansplatz, München, Deutschland.
Abstract
BACKGROUND: Facial plastic and reconstructive surgery requires delicate, atraumatic handling of cartilage, bone and the surrounding soft tissue. Piezoelectric instrumentation (PEI) has previously been shown to be a precise and safe surgical instrument in rhinoplasty. It offers good preservation of surrounding soft tissue and high cutting precision and thus a good surgical applicability in rhinoplasty. OBJECTIVE: This article presents experiences using PEI for cartilage preparation and modelling for various indications in facial plastic surgery. The use of PEI in rhinoplasty, its safety and preciseness were evaluated and postoperative results are discussed with respect to facial swelling and bruising. MATERIAL AND METHODS: This retrospective study included 35 patients undergoing rhinoplasty and follow-up. Surgery was conducted by two expert surgeons in rhinoplasty in the department of otorhinolaryngology at the University Clinic of LMU Munich. Surgical performance of PEI in comparison with conventional instruments was evaluated by a customized questionnaire. The postoperative assessment of pain, facial swelling and bruising was documented. RESULTS: This article presents the different options for the use of PEI in rhinoplasty. In bone modelling procedures, such as hump removal, osteotomy and bony fixations, PEI was evaluated as being superior to conventional instruments. Intraoperative bleeding was reduced, which led to reduced facial swelling and/or bruising. Postoperative pain assessment showed no or only mild pain in two thirds of the patients. CONCLUSION: The results show that PEI enables a safe and very precise operation. Further development of surgical inserts will enable new surgical steps and facilitate the handling.
BACKGROUND:Facial plastic and reconstructive surgery requires delicate, atraumatic handling of cartilage, bone and the surrounding soft tissue. Piezoelectric instrumentation (PEI) has previously been shown to be a precise and safe surgical instrument in rhinoplasty. It offers good preservation of surrounding soft tissue and high cutting precision and thus a good surgical applicability in rhinoplasty. OBJECTIVE: This article presents experiences using PEI for cartilage preparation and modelling for various indications in facial plastic surgery. The use of PEI in rhinoplasty, its safety and preciseness were evaluated and postoperative results are discussed with respect to facial swelling and bruising. MATERIAL AND METHODS: This retrospective study included 35 patients undergoing rhinoplasty and follow-up. Surgery was conducted by two expert surgeons in rhinoplasty in the department of otorhinolaryngology at the University Clinic of LMU Munich. Surgical performance of PEI in comparison with conventional instruments was evaluated by a customized questionnaire. The postoperative assessment of pain, facial swelling and bruising was documented. RESULTS: This article presents the different options for the use of PEI in rhinoplasty. In bone modelling procedures, such as hump removal, osteotomy and bony fixations, PEI was evaluated as being superior to conventional instruments. Intraoperative bleeding was reduced, which led to reduced facial swelling and/or bruising. Postoperative pain assessment showed no or only mild pain in two thirds of the patients. CONCLUSION: The results show that PEI enables a safe and very precise operation. Further development of surgical inserts will enable new surgical steps and facilitate the handling.
Authors: H Breivik; P C Borchgrevink; S M Allen; L A Rosseland; L Romundstad; E K Breivik Hals; G Kvarstein; A Stubhaug Journal: Br J Anaesth Date: 2008-05-16 Impact factor: 9.166