title: External osteotomy in rhinoplasty: Piezosurgery vs osteotome.
abstract: OBJECTIVE
  To achieve the desired outcome in rhinoplasty depends on many factors. Osteotomy and surgical reshaping of nasal bones are important steps that require careful planning and execution. The availability of different tools raises the question of which one provides significant advantages for both technique and surgical outcome. Our prospective randomized pilot study compared the outcome of post-traumatic rhinoplasty performed with two different external techniques: ultrasound osteotomic cut using the Piezosurgery Medical Device (Mectron, Carasco, Italy) and traditional external osteotomy.
  
  
  METHODS
  Forty-four lateral osteotomies of the nasal wall were performed in twenty-two patients. In twelve patients the osteotomies were conducted with a 2-mm traditional osteotome (control group), while in the remaining ten patients these were done with the Piezosurgery Medical Device (experimental group).
  
  
  RESULTS
  At the postoperative evaluation, significantly lower pain, edema and ecchymosis were noticed in the experimental group (p<0.05). Moreover, the endoscopic evaluation showed fewer mucosal injuries in the experimental group (p<0.05), whereas bleeding, symmetry of the pyramid and presence of external scars, were similar in the two groups.
  
  
  CONCLUSIONS
  In the present study, Piezosurgery Medical Device allowed for safe lateral osteotomies in rhinoplasty preliminarily demonstrating the potential to reduce some of the most frequent complications of rhinoplasty.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Strada di Fiume 447, Trieste, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tirelli
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Strada di Fiume 447, Trieste, Italy. Electronic address: margheritatofanelli@hotmail.com.
authors.forename: Margherita
authors.initials: M
authors.lastname: Tofanelli
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Strada di Fiume 447, Trieste, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Bullo
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Strada di Fiume 447, Trieste, Italy.
authors.forename: Max
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Department of Maxillofacial Surgery, University Hospital of Udine, Piazzale Santa Maria della Misericordia 15, Udine, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Robiony
mesh_terms: D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D009295:Nasal Bone / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation*; D059745:Piezosurgery / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome