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Analysis of Factors Affecting Postoperative Drainage After Comprehensive Rhinoplasty. J Craniofac Surg 2022; 33:e604-e606. [PMID: 35882255 DOI: 10.1097/scs.0000000000008682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/06/2022] [Indexed: 11/27/2022] Open
Abstract
This study aimed to explore and analyze the factors influencing the drainage volume after comprehensive rhinoplasty. The clinical data of 102 patients who underwent comprehensive rhinoplasty at Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from August 2019 to August 2021 were retrospectively analyzed. The effects of age, sex, body mass index, whether an osteotomy was performed, and whether a nasal septum flap was obtained on the indwelling time of the drainage tube after the operation were analyzed by single factor analysis and multiple logistic regression analysis. Age, body mass index, whether it was a primary rhinoplasty, whether an osteotomy was performed, and whether a nasal septum flap was obtained were the influencing factors for drainage time after augmentation rhinoplasty ( P <0.05). Sex had little effect on the drainage time after comprehensive rhinoplasty ( P >0.05). Body mass index, whether an osteotomy was performed and whether a nasal septum flap was obtained were the independent influencing factors for the postoperative drainage time ( P <0.05). For patients with multiple independent influencing factors, individualized management during the perioperative period should be promoted, and reasonable treatment strategies should be formulated, so as to reduce the indwelling time of the drainage tube after the operation.
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Lamassoure L, Giunta J, Rosi G, Poudrel AS, Meningaud JP, Bosc R, Haïat G. Anatomical subject validation of an instrumented hammer using machine learning for the classification of osteotomy fracture in rhinoplasty. Med Eng Phys 2021; 95:111-116. [PMID: 34479687 DOI: 10.1016/j.medengphy.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 11/24/2022]
Abstract
Osteotomies during rhinoplasty are usually based on the surgeon's proprioception to determine the number and the strength of the impacts. The aim of this study is to determine whether a hammer instrumented with a force sensor can be used to classify fractures and to determine the location of the osteotome tip. Two lateral osteotomies were realized in nine anatomical subjects using an instrumented hammer recording the evolution of the impact force. Two indicators τ and λ were derived from the signal, and video analysis was used to determine whether the osteotome tip was located in nasal or frontal bone as well as the condition of the bone tissue around the osteotome tip. A machine-learning algorithm was used to predict the condition of bone tissue after each impact. The algorithm was able to predict the condition of the bone after the impacts with an accuracy of 83%, 91%, and 93% when considering a tolerance of 0, 1, and 2 impacts, respectively. Moreover, in nasal bone, the values of τ and λ were significantly lower (p < 10-10) and higher (p < 10-4) than in frontal bone, respectively. This study paves the way for the development of the instrumented hammer as a decision support system.
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Affiliation(s)
- Léo Lamassoure
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, 61 avenue du Général de Gaulle, Créteil 94010, France
| | - Justine Giunta
- Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Plastic, Reconstructive, 50 avenue du Maréchal de Lattre de Tassigny 94000 Créteil, France
| | - Giuseppe Rosi
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, 61 avenue du Général de Gaulle, Créteil 94010, France
| | - Anne-Sophie Poudrel
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, 61 avenue du Général de Gaulle, Créteil 94010, France
| | - Jean-Paul Meningaud
- Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Plastic, Reconstructive, 50 avenue du Maréchal de Lattre de Tassigny 94000 Créteil, France
| | - Romain Bosc
- Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Plastic, Reconstructive, 50 avenue du Maréchal de Lattre de Tassigny 94000 Créteil, France; Faculty of Medicine, INSERM U955 IMRB, UPEC Paris Est-Creteil University, Team 10, Creteil F-94000, France
| | - Guillaume Haïat
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, 61 avenue du Général de Gaulle, Créteil 94010, France.
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Giunta J, Lamassoure L, Nokovitch L, Rosi G, Poudrel AS, Meningaud JP, Haïat G, Bosc R. Validation of an Instrumented Hammer for Rhinoplasty Osteotomies: A Cadaveric Study. Facial Plast Surg Aesthet Med 2021; 24:369-374. [PMID: 34449254 DOI: 10.1089/fpsam.2021.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Osteotomies during rhinoplasty are usually based on surgeon's proprioception to determine the number, energy, and trajectory of impacts. Objective: The first objective was to detect the occurrence of fractures. The second objective was to determine when the thicker frontal bone was encountered by the osteotome. Materials and Methods: An instrumented hammer was used to measure the impact force during lateral osteotomies on nine human anatomic specimens. A prediction algorithm was developed using machine learning techniques, to detect the occurrence of fractures, and the proximity of the osteotome to the frontal bone. Results: The algorithm was able to predict the occurrence of fractures and the proximity to the frontal bone with a prediction rate of 83%, 91%, and 93% when allowing for an error of 0, 1, and 2 impacts, respectively. The location of the osteotome in the frontal bone was predicted with an error of 7.7%. Conclusion: An osteotomy hammer measuring the impact force when performing lateral osteotomies can predict the occurrence of fractures and the proximity to the frontal bone, providing the surgeon with instant feedback.
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Affiliation(s)
- Justine Giunta
- Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Créteil, France.,CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, Créteil, France
| | - Léo Lamassoure
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, Créteil, France
| | - Lara Nokovitch
- Maxillo-Facial Surgery Department, Hôpital Beaujon, Clichy, France
| | - Giuseppe Rosi
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, Créteil, France
| | - Anne-Sophie Poudrel
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, Créteil, France
| | - Jean-Paul Meningaud
- Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Créteil, France
| | - Guillaume Haïat
- CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, Créteil, France
| | - Romain Bosc
- Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Créteil, France.,INSERM U955 IMRB, Team 10, Creteil, France.,Faculty of Medicine, UPEC Paris Est-Creteil University, Creteil, France
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A Simple Solution for Infractured Lateral Nasal Osteotomy Lines During Revision or Primary Rhinoplasty: Osseos Stabilization With Polydioxanone Sutures. J Craniofac Surg 2021; 32:e103-e106. [PMID: 32675761 DOI: 10.1097/scs.0000000000006765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT In addition to precautions taken with perioperative surgical techniques, nasal packing and external nasal splinting are frequently employed to ensure the stability of the nasal bones following osteotomies performed during rhinoplasty. However, despite these precautions, nasal bone fragments, generally caused by trauma or healing problems, can approach the midline, progress in a posterior direction and heal with malunion in an infractured manner. Since cavities on the infractured side can result in asymmetries and/or airway narrowing, revision osteotomy is required to correct these problems. Subsequent potential recurrent infractures caused by nasal fragments can easily be prevented with late-absorbed sutures passing through the neighboring holes and opening near the osteotomy lines. This technique would be useful for both primary and secondary rhinoplasty, but especially in secondary rhinoplasty operations. (Level of Evidence: Level IV).
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Ho M, Goldfarb J, Moayer R, Nwagu U, Ganti R, Krein H, Heffelfinger R, Hutchinson ML. Design and Printing of a Low-Cost 3D-Printed Nasal Osteotomy Training Model: Development and Feasibility Study. JMIR MEDICAL EDUCATION 2020; 6:e19792. [PMID: 33200998 PMCID: PMC7708083 DOI: 10.2196/19792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/26/2020] [Accepted: 10/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Nasal osteotomy is a commonly performed procedure during rhinoplasty for both functional and cosmetic reasons. Teaching and learning this procedure proves difficult due to the reliance on nuanced tactile feedback. For surgical simulation, trainees are traditionally limited to cadaveric bones, which can be costly and difficult to obtain. OBJECTIVE This study aimed to design and print a low-cost midface model for nasal osteotomy simulation. METHODS A 3D reconstruction of the midface was modified using the free open-source design software Meshmixer (Autodesk Inc). The pyriform aperture was smoothed, and support rods were added to hold the fragments generated from the simulation in place. Several models with various infill densities were printed using a desktop 3D printer to determine which model best mimicked human facial bone. RESULTS A midface simulation set was designed using a desktop 3D printer, polylactic acid filament, and easily accessible tools. A nasal osteotomy procedure was successfully simulated using the model. CONCLUSIONS 3D printing is a low-cost, accessible technology that can be used to create simulation models. With growing restrictions on trainee duty hours, the simulation set can be used by programs to augment surgical training.
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Affiliation(s)
- Michelle Ho
- Health Design Lab, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jared Goldfarb
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Roxana Moayer
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Uche Nwagu
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Rohan Ganti
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Howard Krein
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Ryan Heffelfinger
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, United States
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