Piezosurgery Versus Conventional Osteotomy in Prelacrimal Approach for Maxillary Sinus.
Ahmed Gad Esmail, Eman H Salem, Aya Mohammed Abdel Aziz et al.
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In 30 seconds
This prospective randomized controlled study compared piezosurgery with conventional osteotomy during the prelacrimal approach in 40 patients with maxillary sinus pathologies. Piezosurgery was associated with substantially less blood loss (14 ± 3.84 vs. 42 ± 16.81; p = 0.001), but longer operative time (16.30 ± 2.16 vs. 9.05 ± 1.88; p = 0.001). Postoperative pain, hypoesthesia, and epiphora were also significantly less with piezosurgery and resolved spontaneously. Both groups improved on NOSE and SNOT-22 scores, while other reported complications were comparable.
Key findings
- Blood loss was lower with piezosurgery than conventional osteotomy (14 ± 3.84 vs. 42 ± 16.81; p = 0.001).
- Operative time was longer with piezosurgery (16.30 ± 2.16 vs. 9.05 ± 1.88; p = 0.001).
- Pain, hypoesthesia, and epiphora were significantly less with piezosurgery (p < 0.001, p = 0.006, p = 0.002) and resolved spontaneously.
- NOSE and SNOT-22 scores improved in both groups at 3-month and 6-month follow-up compared with preoperative scores (p < 0.001).
Why it matters
The findings highlight a trade-off between reduced bleeding and transient postoperative symptoms with piezosurgery and the longer operative time it requires. For maxillary sinus procedures using a prelacrimal approach, these comparative outcomes can inform assessment of the technique’s potential benefits and procedural costs, while the comparable rates of other reported complications provide additional context.
What to keep in mind
The study included 40 patients at a single university department; follow-up outcomes were reported through 6 months.