Since its inception, Rhinoplasties have been based on the use of mechanical instruments, such as chisels, rasps, or gouges, to model the bony part of the nose. Apart from the improvement of the materials with which this instrument has been manufactured (high-quality steels, titanium, carbon edges, etc.), there has been no overwhelming invasion of surgical equipment. For a few years now, piezo-electric devices have been incorporated into Rhinoplasties, promising a series of benefits for both the surgeon and patients. In this article, we will review what is known as Ultrasonic Rhinoplasty, why it is used, how it works, and when it is truly useful.
What Does The Piezo-Electric Technology Used During An Ultrasonic Rhinoplasty Consist Of?
The term piezo-electric derives from the Greek « piezin, «which means to press or squeeze. The piezo-electric effect was first described by Marie and Jean Curie in 1880, and its operation is based on the behavior of certain crystals when they are subjected to an electric charge or pressure. Using this technology, an ultrasonic oscillation frequency can be obtained that has proven to be very useful for making precise cuts in hard materials, such as bone. In this sense, frequencies between 26-29 Khz are especially useful because the device will be able to cut bone without affecting soft tissue.
What Practical Uses Does Ultrasonic Rhinoplasty Have?
We must be clear:
- – Ultrasonic rhinoplasty is not a different way of «doing rhinoplasties,» just a way of treating the bony part of the nose.
- – Don’t be confused; With piezo-electric instruments, only the bony part of the nose can be treated (approximately 1/3 of the nose). The other 2/3 of the nasal architecture are treated “without ultrasound.”
The use of ultrasound (piezo-electric instruments) in rhinoplasty is useful for:
- – Accurate, targeted, and relatively less traumatic bone cuts than with traditional instruments.
- – Customized osteoplasties. It is also possible to scrape or model the bone in a more progressive, delicate, and controlled way.
- – In segments of hard cartilage (such as the rib), it is useful to obtain grafts with precision and less risk.
- – It is helpful in certain septoplasties (nasal septum operations) where conventional instruments can be too aggressive or dangerous.
Ultrasonic rhinoplasty can be used with closed rhinoplasty techniques for very specific and limited steps such as osteotomies. But where the full potential of Ultrasonic Rhinoplasty is truly exploited is during open rhinoplasties. It must be borne in mind that one of the most interesting facets of the piezo-electric instruments is the irrigation of the tissues with pressure serum. This benefit cannot be obtained if the instruments are used during a closed rhinoplasty.