The Impact of Osteotomies in Rhinoplasty on Systemic Inflammation and Early Postoperative Quality of Life

Objectives: This study evaluated early postoperative systemic inflammation, periorbital ecchymosis, edema, and quality of life in patients undergoing rhinoplasty with conventional osteotomy, piezoelectric osteotomy, or no osteotomy. Methods: This prospective study included 175 patients divided into 3 groups: group 1 (n=80), conventional osteotomy; group 2 (n=63), piezoelectric osteotomy; and group 3 (n=32), no osteotomy. Preoperative and postoperative day 1 blood samples were analyzed for neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory marker (SIM), hemoglobin (Hb), CRP, ESR, and albumin. Postoperative evaluation included edema, ecchymosis scores, and the Quality of Recovery-15 (QoR-15) questionnaire. Results: Neutrophil-to-lymphocyte ratio increase and Hb decrease were significant in groups 1 and 2 compared with group 3, whereas SII increase was significantly higher in group 2 than in group 3. No differences were found between groups 1 and 2 for these parameters. Edema and ecchymosis were significantly lower in group 3, with ecchymosis also lower in group 2 compared with group 1, but no differences in edema were observed between groups 1 and 2. QoR-15 scores were significantly higher in group 3 than in groups 1 and 2, with no differences between groups 1 and 2. Conclusion: The no-osteotomy group showed better outcomes in inflammation, edema, ecchymosis, and QoR-15 scores, suggesting that increased inflammation is linked to osteotomy rather than the technique used. While ecchymosis differed between conventional osteotomy and piezosurgery, this did not impact inflammation or quality of life.