Klasik osteotom ve elektrikli mikrotestere osteotom ile yapılan rinoplasti operasyonu sonrasında ödem, ekimoz ve ağrının karşılaştırılması
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Tarih
2023
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalıĢmada konvensiyonel (klasik) osteotomi ve güçlendirilmiĢ (elektrikli) mikro-testere osteotomi teknikleri ile yapılan rinoplasti ameliyatı sonrası oluĢan ödem, ekimoz ve ağrıyı karĢılaĢtırmayı amaçladık.
Materyal ve Method: Aralık 2022 ve Mayıs 2023 tarihleri arasında Necmettin Erbakan Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları Anabilim Dalı'nda yaĢları 18 ile 45 arasında olmak üzere toplam 90 hasta dahil edildi. 45 hastaya elektrikli testere enstrümanlar yadımıyla medial, lateral ve transvers osteotomi uygulandı, 45 hastaya ise konvensiyonel yöntem yardımıyla osteotomi uygulandı. Hastaların postoperatif birinci gün, üçüncü gün ve yedinci gün ödem, ekimoz, ağrı değerleri, bir KBB Hastalıkları uzmanlık öğrencisi tarafından, yapılan osteotomi yönteminden habersiz (tek kör) olarak Kara ve Gokalan ödem ekimoz sınıflamasının Yücel modifikasyonu kullanılarak kaydedildi. Ayrıca ağrı için Görsel Analog skala (VAS) ağrı ölçeği kullanılarak kaydedildi.
Bulgular: YaĢ ve cinsiyete göre gruplar arasında istatistiksel olarak anlamlı farklar saptanmadı. Postoperatif 1. gün ve 3. gün ödem skorlarının Elektrikli mikrotestere osteotomi uygulanan hasta grubunda (grup 1), klasik osteotomi (grup 2) grubuna göre düĢük düzeylerde olduğu, postoperatif 7. gün ödem skorlarının ise grup 1‟de grup 2‟e göre biraz daha düĢük seviyelerde olduğu, ancak aradaki farkların istatistiksel olarak anlamlı olmadığı belirlendi. Grup 2 „de postoperatif 1. gün ve 3. gün ekimoz skorlarının grup 1 „e göre istatistiksel olarak anlamlı Ģekilde yüksek düzeylerde olduğu, buna karĢın 7. gün ekimoz skorlarının tedavi grupları arasında anlamlı farklar ortaya koymadığı belirlendi. Ağrı açısından değerlendirdiğimizde grup 2 „de postoperatif 1. Gün ağrı skorlarının(VAS) grup 1 „e göre istatistiksel olarak anlamlı Ģekilde yüksek olduğu (p=0.011), buna karĢın 3. gün ve 7. Gün VAS‟ın tedavi grupları arasında anlamlı farklar ortaya koymadığı belirlendi.
Sonuç: Rinoplasti sonrası sık karĢılaĢtığımız morbidetelerden ödem, ekimoz ve ağrı hastaların en önemli sorunlarındandır. Rinoplasti sonrası erken dönemde ekimoz ve ağrının azaltılmasında elektrikli testere yönteminin klasik yönteme göre daha etkili olduğu görüldü. Ancak postoperatif 7. Gün ödem, ekimoz ve ağrı değerlendirmesinin benzer olduğu sonucuna varıldı. Elektrikli testere, osteotomi aĢamasında konvansiyonel yönteme kıyasla etkin, güvenilir ve alternatif bir yöntem olarak kullanılabileceği düĢünüldü.
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 February 2022 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.
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 February 2022 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.
Açıklama
Anahtar Kelimeler
Rinoplasti, Osteotomi, Mikrotestere, Ödem, Ekimoz, Rhinoplasty, Osteotomy, Micro-saw, Edema, Ecchymosis
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Bayrakcı, E. (2023). Klasik osteotom ve elektrikli mikrotestere osteotom ile yapılan rinoplasti operasyonu sonrasında ödem, ekimoz ve ağrının karşılaştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Kulak Burun Boğaz Anabilim Dalı, Konya.
