Comparison of edema, echymosis and pain after rhinoplasty operation with conventional osteotom and powered micro saw osteotom

Objective: In this study, we aimed to compare edema, ecchymosis and pain after rhinoplasty surgery performed with conventional (classical) osteotomy and powered (electric) micro-saw osteotomy techniques. Materials and Methods: Between December 2021 and May 2023, 90 patients between the ages of 18 and 45 were included in the Department of Otorhinolaryngology, Necmettin Erbakan University Faculty of Medicine. Among them, 45 patients underwent medial, lateral, and transverse osteotomy with powered saw instruments, while the remaining 45 patients underwent osteotomy using the conventional method. An ENT Diseases specialist evaluated edema, ecchymosis, and pain on postoperative first day, third day, and seventh day. The specialist was unknowing of the osteotomy method used (single-blind). Edema and ecchymosis were classified using the Yücel modification of the Kara and Gokalan classification. Pain scores were recorded using the Visual Analog Scale (VAS). Results: There were no statistically significant differences between the groups according to age and gender. After the surgery, edema scores on the postoperative 1st and 3rd days were significantly lower in the patient group treated with electric micro-saw osteotomy (group 1) compared to the classical osteotomy group (group 2). However, the edema scores on the 7th day were slightly lower in group 1 compared to group 2, but these differences were not statistically significant. On the other hand, in group 2, the postoperative 1st and 3rd-day ecchymosis scores were statistically significantly higher than in group 1, but there were no statistically significant differences in the ecchymosis scores on the 7th day between the groups. When evaluating pain, it was found that on the postoperative 1st day, the VAS values were statistically significantly higher in group 2 compared to group 1 (p=0.011). However, there were no statistically significant differences in the VAS values on the 3rd and 7th days between the treatment groups. Conclusion: After rhinoplasty, edema, ecchymosis, and pain are among the most common morbidities encountered by patients. We concluded that the use of a powered micro-saw is effective in reducing ecchymosis and pain during the early stages compared to the conventional method, but edema, ecchymosis, and pain were similar on the 7th postoperative day. Therefore, It was thought that the electric saw could be used as an effective, reliable and alternative method compared to the conventional method in the osteotomy step.