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Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis

Previous systematic reviews evaluating piezoelectric osteotomy are of critically low quality. We conducted a high-quality systematic review and meta-analysis to evaluate outcomes for piezoelectric versus conventional osteotomy. METHODS: The study protocol was published a priori (PROSPERO: CRD4202128...

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Autores principales: Khajuria, Ankur, Krzak, Ada M., Reddy, Rohin K, Lai, Kenneth, Wignakumar, Thirushan, Rohrich, Rod J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699654/
https://www.ncbi.nlm.nih.gov/pubmed/36448013
http://dx.doi.org/10.1097/GOX.0000000000004673
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author Khajuria, Ankur
Krzak, Ada M.
Reddy, Rohin K
Lai, Kenneth
Wignakumar, Thirushan
Rohrich, Rod J.
author_facet Khajuria, Ankur
Krzak, Ada M.
Reddy, Rohin K
Lai, Kenneth
Wignakumar, Thirushan
Rohrich, Rod J.
author_sort Khajuria, Ankur
collection PubMed
description Previous systematic reviews evaluating piezoelectric osteotomy are of critically low quality. We conducted a high-quality systematic review and meta-analysis to evaluate outcomes for piezoelectric versus conventional osteotomy. METHODS: The study protocol was published a priori (PROSPERO: CRD42021287877). MEDLINE, Embase, Web of Science, and CENTRAL 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. Random effects models were applied. RESULTS: Of 347 articles, 10 studies (nine randomized controlled trials; one prospective cohort study) including 554 patients were included. Piezoelectric osteotomy was associated with significantly reduced edema [standardized mean difference (SMD), −0.67; 95% confidence interval (CI), −1.03 to −0.30; P < 0.0004], ecchymosis (SMD, −0.93; 95% CI, −1.13 to −0.73; P < 0.00001), and pain (SMD, −1.48; 95% CI, −2.07 to −0.88; P < 0.00001) compared with standard osteotomy. Odds of mucosal injury were significantly lower following piezoelectric osteotomy (odds ratio, 0.06; 95% CI, 0.01 to 0.52; P = 0.01). There was no difference in duration of osteotomy (SMD, 3.15; 95% CI, −1.82 to 8.12; P = 0.22) or total procedure duration (SMD, 0.46; 95% CI, −0.43 to 1.36; P = 0.31). One study reported PROs, favoring piezoelectric osteotomy. CONCLUSION: This systematic review and meta-analysis provides support (albeit weak, due to low-quality evidence) for piezoelectric over conventional osteotomy, for reducing morbidity in the early postoperative period. High-quality level I data reporting PROs will optimize shared decision-making/informed consent.
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spelling pubmed-96996542022-11-28 Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis Khajuria, Ankur Krzak, Ada M. Reddy, Rohin K Lai, Kenneth Wignakumar, Thirushan Rohrich, Rod J. Plast Reconstr Surg Glob Open Cosmetic Previous systematic reviews evaluating piezoelectric osteotomy are of critically low quality. We conducted a high-quality systematic review and meta-analysis to evaluate outcomes for piezoelectric versus conventional osteotomy. METHODS: The study protocol was published a priori (PROSPERO: CRD42021287877). MEDLINE, Embase, Web of Science, and CENTRAL 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. Random effects models were applied. RESULTS: Of 347 articles, 10 studies (nine randomized controlled trials; one prospective cohort study) including 554 patients were included. Piezoelectric osteotomy was associated with significantly reduced edema [standardized mean difference (SMD), −0.67; 95% confidence interval (CI), −1.03 to −0.30; P < 0.0004], ecchymosis (SMD, −0.93; 95% CI, −1.13 to −0.73; P < 0.00001), and pain (SMD, −1.48; 95% CI, −2.07 to −0.88; P < 0.00001) compared with standard osteotomy. Odds of mucosal injury were significantly lower following piezoelectric osteotomy (odds ratio, 0.06; 95% CI, 0.01 to 0.52; P = 0.01). There was no difference in duration of osteotomy (SMD, 3.15; 95% CI, −1.82 to 8.12; P = 0.22) or total procedure duration (SMD, 0.46; 95% CI, −0.43 to 1.36; P = 0.31). One study reported PROs, favoring piezoelectric osteotomy. CONCLUSION: This systematic review and meta-analysis provides support (albeit weak, due to low-quality evidence) for piezoelectric over conventional osteotomy, for reducing morbidity in the early postoperative period. High-quality level I data reporting PROs will optimize shared decision-making/informed consent. Lippincott Williams & Wilkins 2022-11-23 /pmc/articles/PMC9699654/ /pubmed/36448013 http://dx.doi.org/10.1097/GOX.0000000000004673 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/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) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , 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.
spellingShingle Cosmetic
Khajuria, Ankur
Krzak, Ada M.
Reddy, Rohin K
Lai, Kenneth
Wignakumar, Thirushan
Rohrich, Rod J.
Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis
title Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis
title_full Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis
title_fullStr Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis
title_full_unstemmed Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis
title_short Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis
title_sort piezoelectric osteotomy versus conventional osteotomy in rhinoplasty: a systematic review and meta-analysis
topic Cosmetic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699654/
https://www.ncbi.nlm.nih.gov/pubmed/36448013
http://dx.doi.org/10.1097/GOX.0000000000004673
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