Piezo Technique in Rhinoplasty

Introduction:

In rhinoplasty, the bone traditionally is treated by classical instruments (hammer, chisel, osteotome, rasps). Disadvantages are missing direct vision to the surgical field, as well as reduced precision and safety with osteotomy and hump removal. The newer piezo technique uses the cutting effect of ultrasound technology with more than 30.000 vibrations per second.

Methods:

We used the Piezosurgery® instrument (mectron s.p.a., Carasco, Italy) with a number of different inserts for shaping and cutting the bone, and compared it to classical rhinoplasty instruments in specimens and clinical settings. The results of a clinical study have also been integrated into the evaluation.

Results:

Piezo technique allows for highly precise treatment of bone, with hump removal as well as osteotomy. All steps are under direct vision. The water jet needed is also cooling the tissues. The technique enables new modifications of handling the bone, like incomplete osteotomy with gentle shaping of bone fragments. The piezo instrument acts almost exclusively on bone, with few interactions with soft tissue. The procedure needs an extended open approach; however, no negative effect on patient comfort has been observed.

Conclusions:

Compared to classical instruments, Piezo technique offers a wider spectrum of treatment options with shaping and cutting of bone in rhinoplasty. Soft tissue is at low risk of damage, we have not seen marked negative effects on patient comfort. Piezo technique is a valuable new contribution to the armamentarium in rhinoplasty.

Publication History

Publication Date:
23 April 2019 (online)