The Effects of Vibration and Pressure Treatments in the Early Postoperative Period of Rhinoplasty

Overview

Swelling and bruising in the first week are the most distressing part of rhinoplasty recovery for patients. This prospective randomized study compared the standard nasal cast against a cast held under pressure by a bandage, and against that same setup plus vibration treatment.

Sections of note

• 60 patients randomized into 3 groups of 20: group 1 classic nasal casting as control, group 2 nasal cast plus an elastic bandage holding it to the face, group 3 the same plus vibration treatment.
• Assessment was preoperative and at 3 and 7 days after surgery.
• Swelling and bruising were scored by 2 independent surgeons; pain was measured on a visual analogue scale.
• The need for anti-inflammatory medication and the dose required were recorded, along with cast comfort.
• Skin oil production over the nose was examined.
• Ultrasound was performed before surgery and on postoperative day 7 to measure tissue swelling objectively.
• Pressure treatment significantly decreased swelling and bruising versus control; vibration further minimized swelling, bruising, skin oiliness, pain score and medication need, and increased cast comfort, all P below 0.0001.

What it means for a patient

• Holding the cast under pressure with a bandage measurably reduced swelling and bruising by itself.
• Adding vibration improved every measure recorded, including comfort of the cast and how much painkiller was needed.
• Assessment ran only to day 7, so effects beyond the first week are unknown.
• Limits: 60 patients in three groups of 20, one center, and surgeons scoring swelling could see which cast a patient had.

Why this paper matters

Recovery appearance and comfort are what patients most want improved, and these interventions are cheap and non-drug. The consistency of the effect across every measure is notable. Blinding was not possible for the visible treatments, which is the main weakness.

Terms

• Nasal cast: The rigid external dressing placed over the nose after surgery.
• Edema: Swelling caused by fluid in tissue.
• Ecchymosis: Bruising under the skin.
• Sebaceous activity: Oil production by glands in the skin.
• Visual analogue scale: A line on which a patient marks pain severity.