Ultrasonic surgery reduces trauma after genioplasty
Plastic and reconstructive surgery could benefit
For patients undergoing plastic surgery of the chin, the use of ultrasonic piezosurgery equipment has been found to reduce trauma, pain, and swelling, when compared to traditional surgical drills, according to reports a study in the The Journal of Craniofacial Surgery.
“Piezosurgery may be a viable alternative to traditional osteotomy technique, as it reduces the degree of inflammation, pain, swelling, and morbidity, improving satisfaction and patient comfort,” according to the report by Dr. Gilberto Sammartino of University of Naples Federico II, Italy, and colleagues.
Complications after genioplasty performed using piezosurgery devices were compared with those from using traditional rotating drills. This relatively new approach uses ultrasonic energy, rather than conventional surgical instruments, for cutting of bone. “Several studies have demonstrated that bone healing using piezosurgery is more rapid than other techniques using drills or burs, thanks to a lower inflammatory bone response,” Dr. Sammartino and coauthors write.
Sammartino’s study included 40 patients scheduled for genioplasty, as a primary procedure or after corrective jaw surgery. Patients were randomly assigned to undergo genioplasty using either piezosurgery, or traditional drills. Pain, healing, and complications were compared from one to 15 days after surgery.
The results showed lower pain scores for patients undergoing piezosurgery, although the difference was significant only on the third and seventh day after surgery. Swelling also seemed to be reduced with piezosurgery, compared to cutting drills.
Both groups experienced reduced sensation in the chin area throughout the first 15 days after surgery, mainly due to nerve stretching. Sensation normalised within six months for all patients in both groups, plus pain and swelling were also completely resolved.
Previous studies show that piezosurgery leads to better control of the inflammatory bone response induced by surgery. Less cell damage also leads to increased bone remodelling after surgery. Dr. Sammartino and colleagues conclude, “Bone undergoes less stress during surgery and thus less pain and swelling postoperatively, which is in agreement with the results found in our trial: pain and discomfort were minimal compared to the traditional technique (saw and drills) especially in the immediate postoperative period of healing (within three days).”