The Evaluation of Piezo and Endonasal Osteotomy Methods on Postoperative Healing Process in Septorhinoplasty

NCT ID: NCT06094348

Last Updated: 2023-10-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-05-19

Study Completion Date

2024-04-19

Brief Summary

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The goal of this observational study is to compare the effect of Piezo and endonasal osteotomy techniques on the healing process of patients undergoing septorhinoplasty surgery. The main question\[s\] it aims to answer are:

* In which osteotomy technique the edema is lesser?
* Which osteotomy technique is better for thick vs thin skinned patients ? In which osteotomy technique the healing process is faster?

Participants will be asked to have an ultrasonic measurement of the nasal dorsum preoperatively and at the first, third and tenth months postoperatively.

Researchers will compare the thick and thin skinned patients to detect which osteotomy technique is superior in the healing process ( lesser edema and faster healing due to skin thickness measurements)

Detailed Description

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The goal of this observational study is to compare the effect of Piezo and endonasal osteotomy techniques on the healing process of patients undergoing septorhinoplasty surgery. The main question\[s\] it aims to answer are:

* In which osteotomy technique the edema is lesser?
* Which osteotomy technique is better for thick vs thin skinned patients ? In which osteotomy technique the healing process is faster?

18-65 years old males or females with nasal septum and/or nasal pyramid deviation and external nasal deformities who are willing to undergo open rhinoplasty procedure will be included in the study. Patients who have a history of previous rhinoplasty/septorhinoplasty procedure, abnormal coagulation parameters (prothrombin time, partial thromboplastin time, bleeding/coagulation time), use of anticoagulant drugs, chronic / inflammatory skin disease and/or chronic skin allergies, systemic diseases (hypertension, diabetes mellitus, bronchial asthma), nasal beautification procedures such as dermal fillings, using oral and/or topical (nasal skin) corticosteroids in three months preoperatively will be excluded.

Participants will be asked to have an ultrasonic measurement of the nasal dorsum preoperatively and at the first, third and tenth months postoperatively.

Researchers will compare the thick and thin skinned patients to detect which osteotomy technique is superior in the healing process ( lesser edema and faster healing due to skin thickness measurements).

Conditions

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Nasal Deformity, Acquired Septum; Deviation, Congenital

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1A- Thick skin, endonasal osteotomy

Patients with mean nasal soft tissue envelope thickness \> 4 mm undergoing classical endonasal osteotomy procedure during rhinoplasty operation

Endonasal osteotomy

Intervention Type PROCEDURE

Patients will undergo median-oblique and lateral osteotomy, with conventional 2 mm guarded, straight osteotome.

Group 1B -Thick skin, piezo osteotomy

Patients with mean nasal soft tissue envelope thickness \> 4 mm undergoing piezosurgery assisted osteotomy procedure during rhinoplasty operation

Piezo assisted osteotomy

Intervention Type DEVICE

Piezo is a system for cutting bone with micrometric ultrasonic piezoelectric vibrations, with varying frequency and cutting energy. The device consists of a platform with a powerful piezoelectric hand piece and employs a functional frequency between 25-29 kHz. The device is fitted with a cooling irrigation system with a 0-60 cc/min variable sterile solution flow. Specific inserts and scalpels act in a linear vibration pattern, with a spatial range between 60 and 210 microns, moved by an ultrasonic power that exceeds 5 watts, reaching up to 16 watts.

Group 2A- Thin skin, endonasal osteotomy

Patients with mean nasal soft tissue envelope thickness \<4 mm undergoing classical endonasal osteotomy procedure during rhinoplasty operation

Endonasal osteotomy

Intervention Type PROCEDURE

Patients will undergo median-oblique and lateral osteotomy, with conventional 2 mm guarded, straight osteotome.

Group 2B- Thin skin, piezo osteotomy

Patients with mean nasal soft tissue envelope thickness \< 4 mm undergoing piezosurgery assisted osteotomy procedure during rhinoplasty operation

Piezo assisted osteotomy

Intervention Type DEVICE

Piezo is a system for cutting bone with micrometric ultrasonic piezoelectric vibrations, with varying frequency and cutting energy. The device consists of a platform with a powerful piezoelectric hand piece and employs a functional frequency between 25-29 kHz. The device is fitted with a cooling irrigation system with a 0-60 cc/min variable sterile solution flow. Specific inserts and scalpels act in a linear vibration pattern, with a spatial range between 60 and 210 microns, moved by an ultrasonic power that exceeds 5 watts, reaching up to 16 watts.

Interventions

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Endonasal osteotomy

Patients will undergo median-oblique and lateral osteotomy, with conventional 2 mm guarded, straight osteotome.

Intervention Type PROCEDURE

Piezo assisted osteotomy

Piezo is a system for cutting bone with micrometric ultrasonic piezoelectric vibrations, with varying frequency and cutting energy. The device consists of a platform with a powerful piezoelectric hand piece and employs a functional frequency between 25-29 kHz. The device is fitted with a cooling irrigation system with a 0-60 cc/min variable sterile solution flow. Specific inserts and scalpels act in a linear vibration pattern, with a spatial range between 60 and 210 microns, moved by an ultrasonic power that exceeds 5 watts, reaching up to 16 watts.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* nasal respiratory dysfunction with the deviation of nasal septum and/or the nasal pyramid

Exclusion Criteria

* previous rhinoplasty/septorhinoplasty procedure
* patients with abnormal coagulation parameters (prothrombin time, partial thromboplastin time, bleeding/coagulation time)
* use of anticoagulant drugs
* chronic / inflammatory skin disease and/or chronic skin allergies
* presence of systemic diseases (hypertension, diabetes mellitus, bronchial asthma)
* nasal beautification procedures such as dermal fillings
* use of oral and/or topical (nasal skin) corticosteroids in three months preoperatively
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haseki Training and Research Hospital

OTHER

Sponsor Role lead

Responsible Party

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ISIL TAYLAN CEBI

principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Isil Taylan Cebi, M.D

Role: PRINCIPAL_INVESTIGATOR

Haseki Training and Research Hospiral

Locations

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Haseki Training and Research Hospital

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Isil Taylan Cebi, M.D

Role: CONTACT

00905072352256

Abdullah Karatas, Assoc. Prof

Role: CONTACT

00905326230218

Facility Contacts

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Isil Taylan Cebi, M.D

Role: primary

00905072352256

Abdullah Karatas, Assoc. Prof.

Role: backup

00905326230218

References

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Gode S, Ozturk A, Kismali E, Berber V, Turhal G. The Effect of Platelet-Rich Fibrin on Nasal Skin Thickness in Rhinoplasty. Facial Plast Surg. 2019 Aug;35(4):400-403. doi: 10.1055/s-0039-1693436. Epub 2019 Jul 15.

Reference Type BACKGROUND
PMID: 31307096 (View on PubMed)

Erdur ZB, Oktem F, Inci E, Yener HM, Ustundag A. Effect of Nasal Soft-Tissue Envelope Thickness on Postoperative Healing Process Following Rhinoplasty. J Craniofac Surg. 2021 Sep 1;32(6):2193-2197. doi: 10.1097/SCS.0000000000007697.

Reference Type BACKGROUND
PMID: 33867511 (View on PubMed)

Stenner M, Koopmann M, Rudack C. Measuring the nose in septorhinoplasty patients: ultrasonographic standard values and clinical correlations. Eur Arch Otorhinolaryngol. 2017 Feb;274(2):855-860. doi: 10.1007/s00405-016-4296-7. Epub 2016 Sep 15.

Reference Type BACKGROUND
PMID: 27628964 (View on PubMed)

Tsikopoulos A, Tsikopoulos K, Doxani C, Vagdatli E, Meroni G, Skoulakis C, Stefanidis I, Zintzaras E. Piezoelectric or Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of Clinical Outcomes. ORL J Otorhinolaryngol Relat Spec. 2020;82(4):216-234. doi: 10.1159/000506707. Epub 2020 Apr 22.

Reference Type BACKGROUND
PMID: 32320977 (View on PubMed)

Kurt Yazar S, Serin M, Rakici IT, Sirvan SS, Irmak F, Yazar M. Comparison of piezosurgery, percutaneous osteotomy, and endonasal continuous osteotomy techniques with a caprine skull model. J Plast Reconstr Aesthet Surg. 2019 Jan;72(1):107-113. doi: 10.1016/j.bjps.2018.08.025. Epub 2018 Sep 4.

Reference Type BACKGROUND
PMID: 30243555 (View on PubMed)

Other Identifiers

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Piezo vs Endonasal osteotomy

Identifier Type: -

Identifier Source: org_study_id

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