Piezoelectric osteotomy versus conventional osteotomy in rhinoplasty: a systematic review and meta-analysis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction:
Prior systematic reviews evaluating piezoelectric osteotomy are of critically low quality. We conducted a high-quality systematic review and meta-analysis (SRMA) to evaluate outcomes for piezoelectric versus conventional osteotomy.
Methods:
The study protocol was published a priori (PROSPERO: CRD42021287877). MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials were searched for studies comparing piezoelectric versus conventional osteotomes and reporting at least one outcome of interest (clinical or patient reported outcomes, PROs). Methodological quality and risk of bias were assessed using GRADE and Cochrane’s RoB-2/ROBINS-I tools respectively. Dersiminion and Laird random effects models were applied.
Results:
Of 347 articles, 10 studies (9 RCTs; 1 prospective cohort study) including 554 patients were included. Piezoelectric osteotomy was associated with significantly reduced oedema (SMD -0.67, 95% CI -1.03 – -0.30, p<0.0004); ecchymosis (SMD -0.93, 95% CI -1.13 – -0.73, p<0.00001); and pain (SMD -1.48, 95% CI -2.07 – -0.88, p<0.00001), compared with standard osteotomy. Odds of mucosal injury was significantly lower following piezoelectric osteotomy (OR 0.06, 95% CI 0.01 – 0.52, p=0.01). There was no difference in duration of osteotomy (SMD 3.15, 95% CI -1.82 – 8.12, p=0.22) or total procedure duration (SMD 0.46, 95% CI -0.43 – 1.36, p=0.31). One study reported PROs, favoring piezoelectric osteotomy. AMSTAR criteria deemed this review high-quality.
Conclusion:
This first methodologically-robust SRMA provides support (albeit weak, due to low-quality evidence) for piezoelectric over conventional osteotomy, for reducing morbidity in the early post-operative period. High-quality Level I data, reporting longer-term follow-up and PROs, are required to optimize shared decision-making and informed consent.
Prior systematic reviews evaluating piezoelectric osteotomy are of critically low quality. We conducted a high-quality systematic review and meta-analysis (SRMA) to evaluate outcomes for piezoelectric versus conventional osteotomy.
Methods:
The study protocol was published a priori (PROSPERO: CRD42021287877). MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials were searched for studies comparing piezoelectric versus conventional osteotomes and reporting at least one outcome of interest (clinical or patient reported outcomes, PROs). Methodological quality and risk of bias were assessed using GRADE and Cochrane’s RoB-2/ROBINS-I tools respectively. Dersiminion and Laird random effects models were applied.
Results:
Of 347 articles, 10 studies (9 RCTs; 1 prospective cohort study) including 554 patients were included. Piezoelectric osteotomy was associated with significantly reduced oedema (SMD -0.67, 95% CI -1.03 – -0.30, p<0.0004); ecchymosis (SMD -0.93, 95% CI -1.13 – -0.73, p<0.00001); and pain (SMD -1.48, 95% CI -2.07 – -0.88, p<0.00001), compared with standard osteotomy. Odds of mucosal injury was significantly lower following piezoelectric osteotomy (OR 0.06, 95% CI 0.01 – 0.52, p=0.01). There was no difference in duration of osteotomy (SMD 3.15, 95% CI -1.82 – 8.12, p=0.22) or total procedure duration (SMD 0.46, 95% CI -0.43 – 1.36, p=0.31). One study reported PROs, favoring piezoelectric osteotomy. AMSTAR criteria deemed this review high-quality.
Conclusion:
This first methodologically-robust SRMA provides support (albeit weak, due to low-quality evidence) for piezoelectric over conventional osteotomy, for reducing morbidity in the early post-operative period. High-quality Level I data, reporting longer-term follow-up and PROs, are required to optimize shared decision-making and informed consent.
Date Issued
2022-11
Date Acceptance
2022-09-27
Citation
Plastic and Reconstructive Surgery Global Open, 2022, 10 (11), pp.1-11
ISSN
2169-7574
Publisher
Lippincott, Williams & Wilkins
Start Page
1
End Page
11
Journal / Book Title
Plastic and Reconstructive Surgery Global Open
Volume
10
Issue
11
Copyright Statement
Copyright © 2022 The Authors. Published by Wolters Kluwer Health,
Inc. on behalf of The American Society of Plastic Surgeons. This
is an open-access article distributed under the terms of the Creative
Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the
work provided it is properly cited. The work cannot be changed in
any way or used commercially without permission from the journal.
DOI: 10.1097/GOX.0000000000004673
Inc. on behalf of The American Society of Plastic Surgeons. This
is an open-access article distributed under the terms of the Creative
Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the
work provided it is properly cited. The work cannot be changed in
any way or used commercially without permission from the journal.
DOI: 10.1097/GOX.0000000000004673
Identifier
https://journals.lww.com/prsgo/Fulltext/2022/11000/Piezoelectric_Osteotomy_versus_Conventional.59.aspx?context=LatestArticles
Publication Status
Published
Date Publish Online
2022-11