Comparison Postoperative Complications of a Novel Combined Reciprocal/Osteotome Approach (Ghasemzadeh approach) Versus Conventional Rhinoplasty: A Prospective Clinical Trial Study

Abstract

Objective: This article for the first time described a novel, hybrid approach to internal rhinoplasty by
combining a reciprocating saw/osteotome. We compared it with conventional “pure” instrument (osteotomies
performed by chisel only) in terms of cutting time and postoperative complications such as ecchymosis,
edema, pain and overall patient’s satisfaction with surgery.
Materials and methods: We conducted a prospective, randomized, double-blind clinical trial study. To
assess variables of the study 60 patients were divided into two groups: 1) 30 patients underwent new
approach and 2) 30 patients underwent conventional osteotomies. The outcomes of the study were cutting
time in minutes and postoperative edema, ecchymosis and pain and overall patient’s satisfaction which
were measured at two time points: days 2 and 7 after surgery. Data were analyzed using repeated measure
ANOVA test.
Results: The mean cutting time was significantly lower in Ghasemzadeh approach group when compared
with usual osteotome group (P value=0.001). On both 2 and 7 days following surgery, ecchymosis (P
value=0.001 and =0.033, respectively) and pain (P value= 0.001 and 0.001, respectively) was significantly
lower in Ghasemzadeh approach group than in the usual osteotome group. The mean level of edema on
postoperative 2 days was lower but not significant in Ghasemzadeh approach group than in the usual
osteotome group (P = .09), while it was significant on 7 days (P value=0.001). The patient’s satisfaction
reported by the Ghasemzadeh approach group was significantly better than usual osteotome group on 2 and
7 days following surgery.
Conclusion: It is concluded that the use of combined reciprocating saw/osteotome in rhinoplasty showed
that swelling, pain, ecchymosis and short-term patient satisfaction was improved with this technique.