- 作者：Alireza Ghassemi ; Andreas Prescher ; Mohammad Talebzadeh ; Frank H枚lzle ; Ali Modabber
- 刊名：Journal of Oral and Maxillofacial Surgery
- 出版年：December, 2013
- 年：2013
- 卷：71
- 期：12
- 页码：2155.e1-2155.e6
- 全文大小：1352 K
Purpose
Achieving the desired outcome in rhinoplasty depends on many factors. Osteotomy and adjustment of the lateral nasal wall are important steps that necessitate careful planning and execution. A cadaver study was performed to evaluate the osteotomy result obtained with a newly designed piezoelectric-based scalpel.Materials and Methods
Twenty lateral osteotomies of the nasal wall were performed in 10 human cadaver noses. The osteotomies were conducted in 6 female and 4 male cadavers (age range, 65 to 83 yr; mean age, 74.8 yr). A specially designed Piezosurgery-based scalpel was used endonasally to perform the lateral osteotomy. Cutting of the bony nasal wall was performed subperiostally along the planned osteotomy route under tactile control. Digital infracturing was accomplished by applying gentle pressure. After completing the osteotomy, the osteotomy line and nasal mucosa were examined endoscopically. The skin cover was removed to examine the lateral bony nasal wall for the shape and amount of bone fragments, the osteotomy path, and mucosa involvement.
Results
Using the Piezosurgery-based scalpel required a learning curve, but the handling was easy. It聽allowed an exact performance of the osteotomy and caused no mucosal tearing. If excessive force was used, the piezo tip stopped working. There was no comminuted fracture pattern and the lateral nasal wall remained in 1 piece. The duration of the osteotomy was 5 to 10 minutes on each side.
Conclusion
The piezoelectric-based scalpel is a useful tool, which can be used to perform osteotomy of the nasal wall. In addition, this specifically designed tool tip allows an endonasal approach, is easy to handle, and allows effective irrigation of the osteotomy region.