Laser-Assisted Rhinoplasty: The Future Generation Rhinoplasty Technique to Preserve Anatomy? A Series of Patients Compared to Patients Undergoing Standard Open Rhinoplasty

Overview

The authors developed a small laser hand probe using an erbium yttrium aluminium garnet laser to cut and reshape bone and cartilage, and call the resulting method laser assisted rhinoplasty. The study evaluated whether the technique is feasible and how its appearance and breathing results compare with classic rhinoplasty. Fifty patients were enrolled and randomized into two groups.

Sections of note

• Fifty patients randomized into two cohorts, classic rhinoplasty and laser assisted rhinoplasty.
• The laser beam was used for cutting the tip cartilages, removing the nasal hump and making the bone cuts.
• At clinical assessment, reshaping of the lateral crura produced a visible step or excessive skin retraction in 12 percent of the classic group with thick cartilage or thin skin.
• That finding was absent in the laser group at 12 month follow up.
• The authors state patient satisfaction was higher in the laser group.
• They report clinically noting less swelling immediately after surgery and faster complete resolution of swelling in the laser group.
• No major complications are reported.
• The stated conclusion is comparable aesthetic and functional results with greater precision, higher satisfaction, a cleaner field and less bleeding.

What it means for a patient

• The reported advantage concerns the tip cartilages in patients with thick cartilage or thin skin, where visible steps are a known problem.
• Claims about satisfaction, swelling and bleeding are reported without numbers or statistical tests in the abstract.
• Fifty patients at one centre is small, though the randomized design is stronger than a case series.
• Assessment appears to have been done by the treating team rather than independent blinded raters.

Why this paper matters

Cutting instruments in rhinoplasty have moved from chisels to powered and ultrasonic tools, and lasers are the next proposed step. This trial is an early randomized comparison. The absence of reported statistics for most of its claims limits how much weight they carry.

Terms

• Erbium YAG laser: a laser type that cuts tissue with minimal heat spread to surroundings.
• Lateral crura: the outer arms of the tip cartilages that form the nostril rims.
• Osteotomy: a controlled cut in bone so it can be repositioned.
• Skin retraction: skin pulling tight over an edge, making it visible.
• Edema: swelling from fluid in the tissues.