{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T09:35:54Z","timestamp":1793871354192,"version":"4.6.1"},"reference-count":16,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Lateral osteotomies in rhinoplasty run adjacent to the lacrimal drainage system (LDS), risking postoperative tearing. Piezoelectric (piezo) devices enable precise bone cuts that may reduce LDS trauma. We compared the 1-month incidence of objective lacrimal dysfunction after piezo versus classic osteotomy. Materials and Methods: Retrospective, single-center controlled cohort (1 January 2024\u20131 January 2025) at a tertiary ENT clinic. Consecutive patients aged 19\u201345 with pre-operative paranasal sinus CT and no prior lacrimal disorder were grouped by osteotomy technique (piezo vs. classic; n = 65 per arm). Assessments were performed at postoperative day 7\u201310 and at 1, 3, and 6\u201312 months. The primary endpoint was 1-month objective lacrimal dysfunction, defined as fluorescein dye disappearance test (FDDT) grade \u22651 or reflux\/resistance on irrigation plus symptoms (Munk \u22652). Pre-specified statistical tests were used. Results: Early tearing favored piezo. At week 1, epiphora occurred in 32.3% with piezo versus 46.1% with classic (p = 0.041); by month 6, rates were 4.6% versus 15.1% (p = 0.031). Differences at months 1 and 3 also favored piezo but were not statistically significant (p = 0.062 and p = 0.088). FDDT positivity was lower with piezo at week 1 (23.0% vs. 38.4%, p = 0.045) and month 6 (3.0% vs. 10.7%, p = 0.048). Irrigation obstruction was less frequent with piezo at week 1 (7.6% vs. 21.5%, p = 0.026), but groups converged by months 1 (15.4% vs. 12.3%, p = 0.80) and 3 (6.2% vs. 4.6%, p &gt; 0.99). Punctum stenosis\/occlusion remained uncommon in both groups without significant differences. Conclusions: Piezo-assisted lateral osteotomy is associated with less early lacrimal dysfunction and lower 6-month epiphora compared with the classic technique. Convergence of irrigation findings by 1\u20133 months suggests postoperative edema as the dominant transient mechanism. Given the retrospective, single-center design and low event rates, multicenter prospective studies powered for early LDS outcomes are warranted.<\/jats:p>","DOI":"10.3390\/medicina61111979","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:58:05Z","timestamp":1762329485000},"page":"1979","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Piezoelectric (Piezo) Versus Classic Lateral Osteotomy on the Lacrimal Drainage System (LDS): A Retrospective, Single-Center, Controlled Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6276-8355","authenticated-orcid":false,"given":"Serkan","family":"Dedeo\u011flu","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, University of Health Sciences Gazi Yasargil Training and Research Hospital, Diyarbak\u0131r 21100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8676-6175","authenticated-orcid":false,"given":"G\u00fcnay","family":"Kozan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Clinic, Faculty of Medicine, Dicle University, Diyarbak\u0131r 21100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2421-4842","authenticated-orcid":false,"given":"Muhammed","family":"Ayral","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Clinic, Faculty of Medicine, Dicle University, Diyarbak\u0131r 21100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0667-2866","authenticated-orcid":false,"given":"Bet\u00fcl Dertsiz","family":"Kozan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Health Sciences Gazi Yasargil Training and Research Hospital, Diyarbak\u0131r 21100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1093\/asj\/sjv167","article-title":"The Role of Piezoelectric Instrumentation in Rhinoplasty Surgery","volume":"36","author":"Gerbault","year":"2015","journal-title":"Aesthetic Surg. 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Respir."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/1979\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T08:50:48Z","timestamp":1762332648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/1979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["medicina61111979"],"URL":"https:\/\/doi.org\/10.3390\/medicina61111979","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}