title: Systematic review and meta-analysis of the efficacy of hilotherapy following oral and maxillofacial surgery.
abstract: Craniofacial surgery causes immediate postoperative pain, oedema, and functional limitations. Hilotherapy delivers cooled water to the face at 15°C and may reduce the postoperative recovery time. This work presents a meta-analysis of short-term postoperative outcomes after hilotherapy. Following a systematic literature search, comparative trials of patients undergoing surgical interventions in the maxillofacial region and receiving either hilotherapy or ice-cooling therapy were included for meta-analysis. Demographics and surgical outcomes were extracted. Data were analysed using Comprehensive Meta-Analysis software. Mean (SEM) data were calculated for demographic variables and standardized mean differences with the 95% confidence interval for surgical outcomes. Five trials were analysed, providing 206 patients for evaluation; mean patient age was 29.4 (9.4) years. Hilotherapy reduced pain (10-point visual analogue scale) at 48 h (P<0.010) and 72 h (P<0.050), as well as postoperative facial oedema (P<0.010), compared to ice-cooling treatment. Trismus and facial neurological scores were also improved (P=0.08). Patients preferred hilotherapy to other cooling methods (P<0.010). Hilotherapy appears to be effective in reducing postoperative facial pain, oedema, and trismus, and in improving patient-reported outcomes. Well-designed randomized controlled clinical trials are required to clarify the procedure-specific efficacy of postoperative hilotherapy and optimal durations of treatment.
authors.affiliation: University Hospitals Leicester National Health Service Trust, Leicester UK. Electronic address: anthony.simon.bates@gmail.com.
authors.forename: A S
authors.initials: AS
authors.lastname: Bates
authors.affiliation: Gloucestershire Hospitals National Health Service Foundation Trust, Gloucester, Gloucestershire, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Knepil
mesh_terms: D017679:Cryotherapy / Q000379:methods*; D004487:Edema / Q000209:etiology / Q000628:therapy*; D005157:Facial Pain / Q000209:etiology / Q000628:therapy*; D006801:Humans; D019647:Oral Surgical Procedures; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*
keywords: cryotherapy; face; hilotherapy; hilotherm; hypothermia; induced; meta-analysis; review; surgery