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

Objective: This article for the first time described a novel, hybrid approach to internal rhinoplasty bycombining a reciprocating saw/osteotome. We compared it with conventional “pure” instrument (osteotomiesperformed 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. Toassess variables of the study 60 patients were divided into two groups: 1) 30 patients underwent newapproach and 2) 30 patients underwent conventional osteotomies. The outcomes of the study were cuttingtime in minutes and postoperative edema, ecchymosis and pain and overall patient’s satisfaction whichwere measured at two time points: days 2 and 7 after surgery. Data were analyzed using repeated measureANOVA test.Results: The mean cutting time was significantly lower in Ghasemzadeh approach group when comparedwith usual osteotome group (P value=0.001). On both 2 and 7 days following surgery, ecchymosis (Pvalue=0.001 and =0.033, respectively) and pain (P value= 0.001 and 0.001, respectively) was significantlylower in Ghasemzadeh approach group than in the usual osteotome group. The mean level of edema onpostoperative 2 days was lower but not significant in Ghasemzadeh approach group than in the usualosteotome group (P = .09), while it was significant on 7 days (P value=0.001). The patient’s satisfactionreported by the Ghasemzadeh approach group was significantly better than usual osteotome group on 2 and7 days following surgery.Conclusion: It is concluded that the use of combined reciprocating saw/osteotome in rhinoplasty showedthat swelling, pain, ecchymosis and short-term patient satisfaction was improved with this technique.