How the TAŞ Nasal Splint® Works

A) Effect of the elastic bandage:
 

1. Thanks to the gentle pressure it applies, it limits the oedema that forms after rhinoplasty, especially around the eyes and spreading from the nose to the eye area.

2. It allows the splint to maintain the shape of the nose effectively. With classic splinting, the splint tends to lift because of the marked swelling in the first 48 hours after rhinoplasty, and loses its effect. The TAŞ Nasal Splint® prevents this and keeps the splint in position, so it continues to maintain the shape of the nose.

3. In classic splinting, multiple layers of tape are applied under the splint. These block the skin's pores and trigger sebaceous activity, and patients with thick, oily skin in particular can develop significant acne by the time the splint is removed; some cannot tolerate the itching and ask their surgeon to remove the splint early (Figure 4). With the TAŞ Nasal Splint®, because the splint is effective on its own and provides the necessary gentle pressure, no tape is applied underneath and the skin's contact with air is not blocked. As a result, oiliness, pimples and itching are avoided.

4. With classic splinting, patients cannot shower, because the splint, held in place by adhesives, easily comes off the nose when it gets wet. This affects both the patient's comfort and skin care, and therefore inflammation of the nose. Thanks to its mechanical stability, the TAŞ Nasal Splint® does not prevent showering; after the first 2 days the patient can let water reach the nose without disturbing the splint or the shape of the nose.

5. With classic splinting, patients cannot laugh or bend down because they feel the splint might fall off at any moment. There is no such risk with the TAŞ Nasal Splint®.

6. Because it can be removed easily thanks to its Velcro system, patients travelling from far away can return home after their check-up on the 2nd day after surgery if there are no problems, remove the splint themselves on the 7th day and have an online check-up with their doctor.
    

B) Effect of the micro-vibration motor:
 

1. Micro-vibration (low-magnitude, high-frequency vibration) has an acute analgesic effect, which reduces inflammation and the patient's need for painkillers. This is explained by the gate control theory of pain.

2. Micro-vibration increases lymph and blood flow, helping oedema to disperse faster.

3. Micro-vibration stimulates mesenchymal stem cells in the tissues, speeding wound healing; by stimulating their differentiation it improves tissue quality, activating anabolic and inhibiting catabolic effects.

4. Small bones such as the nasal bones heal with more difficulty and over a longer time; the mechanisms triggered by micro-vibration help the nasal bones heal.

5. With micro-vibration started on the 4th day after surgery, before the splint is removed, massage effectively begins. Patients report that micro-vibration relieves their pain, gets the fluids inside the nose moving so that congestion clears, and makes them more comfortable.

6. The nerve stimulation provided by micro-vibration minimises the risk of post-operative sensitivity and abnormal pain syndromes.

7. To avoid dislodging clots that have formed at the ends of blood vessels, micro-vibration must not be applied in the first 72 hours after surgery. Treatment starts on the 4th day at the earliest and can continue until the 7th day, when the splint is removed. Depending on the locations and durations specified by the surgeon, it can be applied in regimens such as 3 × 30 minutes a day (morning, noon and evening).
   
   This treatment is not used if the patient has developed, or is at risk of developing, a bleeding complication.
    

8. After it is removed on the 7th day, the TAŞ Nasal Splint® is given to the patient, who is asked to wear it at night before sleep, on and off for 2 months. In this way the nose 'remembers' its non-swollen state, and thanks to the splint's micro-vibration the patient may not need to massage the nose.

9. The TAŞ Nasal Splint® offers patients confidence and comfort. In a high-volume patient series, patients' VAS scores, comfort, frequency of painkiller use, sebaceous activity, and levels of oedema and bruising were found to be significantly better than with classic splinting (Figures 5–15).
    

It offers these benefits with a very favourable safety profile, which is why this innovative approach is considered an important development in nasal surgery [3].

One might ask whether the same effect could be obtained simply by placing a micromotor on a classic thermoplastic splint, without the elastic bandage. The answer is no, because of the principles of physics:
 

• When a source emitting vibration energy is placed on a plate, the plate must be fixed for the vibration to pass to the plate and from there to another surface in contact with it; otherwise the vibration energy turns into motion before it can be transferred to the next surface. In that case, micro-vibration would make the splint move out of position. The elastic bandage fixes the plate, that is, the thermoplastic splint, so that micro-vibration can spread from the splint to the subcutaneous tissues; otherwise the energy would be used to move the plate and no vibration would reach the tissues. As a result, the splint would move the nose and cause harm instead of benefit [4].
   

References

1- Title of invention: Vibrating Nasal Splint. Inventor: Süleyman Taş. Turkish Patent Institute registration number: 2016/14675
2-Taş S. The Effects of Vibration and Pressure Treatments in Early Postoperative Period of Rhinoplasty. Aesthet Surg J. 2019 Aug 13. pii: sjz226. doi: 10.1093/asj/sjz226. [Epub ahead of print] Aesthet Surg J. 2020 May 16;40(6):605-616 [Printed]
3- Carlson AR, Marcus JR. Commentary on: The Effects of Vibration and Pressure Treatments in Early Postoperative Period of Rhinoplasty. Aesthet Surg J. 2020 May 16;40 (6):617-618. doi: 10.1093/asj/sjz273.
4-Taş S. The Effects of Vibration Treatment in Rhinoplasty. Aesthet Surg J. 2020 Mar 26. pii: sjaa049. doi: 10.1093/asj/sjaa049. [Epub ahead of print] Aesthet Surg J. 2020 May 16;40(6):NP412-NP415 [Printed]
5- Taş S. Klinik Rinoplasti: Modern Cerrahi Tekniklere Algoritmik Yaklaşım (Turkish translation by Süleyman Taş). Istanbul: İstanbul Tıp Kitabevleri; 2021. (Original title: Taş S. Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques. Taylor & Francis Group, CRC Press; Boca Raton, Florida, New York and London, 2022. DOI: 10.1201/9781003174165)
Figure Captions
Figure 1a: Pre-operative ultrasound measurement of soft-tissue thickness on the side of the nose in a patient treated with classic splinting; measurements were taken at 3 levels: cephalic, middle and caudal.
Figure 1b: Ultrasound of the same patient on day 7 after surgery shows an average 30% increase in tissue thickness due to oedema.
Figure 2a: Pre-operative ultrasound measurement of soft-tissue thickness on the side of the nose in a patient treated with the TAŞ Nasal Splint®.
Figure 2b: Ultrasound of the same patient on day 7 after surgery shows an average 15% increase in tissue thickness due to oedema.
Figure 3a-b: The TAŞ Nasal Splint®. An elastic bandage is sewn to both ends of the thermoplastic splint; its length is set according to the patient's head circumference, and Velcro is sewn to its ends so the bandages can be fastened and released at the back of the head. A micromotor is mounted on the thermoplastic splint with tape, turning it into a vibrating splint.
Figure 4: In a patient treated with classic splinting, severe acne and pimples are noticed when the splint is removed on day 7. For a patient eagerly waiting to see their new nose, this is a difficult situation.
Figure 5:

1. a) The patient before surgery,

2. b) The patient on day 3 after surgery; vibration treatment with the TAŞ Nasal Splint® can begin from this day. c) The patient on day 7, when the TAŞ Nasal Splint® was removed, showing no bruising and minimal swelling.

Figure 6 a-n: The patient before surgery and 7 days after. Oedema is minimal, and the result is comparable to one usually seen only at 2 months with classic splinting. In today's fast-moving world, where time is precious, surgeons need methods that offer faster and more comfortable solutions; the TAŞ Nasal Splint® is an important tool for this.
Figure 7: Another important example of the effectiveness of the TAŞ Nasal Splint®. This patient developed very marked oedema and bruising after surgery. Because individual factors play a major role, oedema and bruising vary greatly from patient to patient. The images show how the patient recovered by day 7 with micro-vibration treatment from the TAŞ Nasal Splint®, started on the 4th day after surgery.

1. a) The patient before surgery,

2. b) The patient on day 3 after surgery; despite the TAŞ Nasal Splint®, the patient had very marked oedema and bruising. Had a classic splint been used, it would already have come off the nose or lifted out of place and lost its ability to control the oedema. A carefully shaped nose becoming distorted by oedema during healing, or grafts or nasal bones shifting, is one of the worst scenarios a nasal surgeon can face.

3. c) Micro-vibration treatment was started immediately and the images show how the patient recovered within 4 days, which is why this innovative approach is considered an important development in nasal surgery.

Figure 8 a-n: The patient before surgery and 7 days after. Despite the marked oedema and bruising in the early period, the result on day 7 is gratifying for both surgeon and patient.
Figure 9: A very interesting case. Although no specific finding was detected in pre-operative screening tests or a detailed history, the patient presented with active bleeding starting 72 hours after surgery. Micro-vibration had not yet been started, as it begins on the 4th day at the earliest. Because of this symptom, no vibration treatment was given and the protocol for bleeding patients was followed. Further tests revealed von Willebrand disease; when asked again about menstrual bleeding, the patient said, 'It lasts a bit long, but it has always been like that.' During the operation, 5 cc of fat had also been aspirated from the abdomen for fat grafting to deep nasolabial folds. Figure 10 shows how the abdomen became bruised and swollen after such a simple procedure as aspirating 5 cc of fat. Yet thanks to the TAŞ Nasal Splint®, note that despite the bleeding disorder there was no bruising or oedema on the face and nose: Figure 9b shows the patient during active bleeding, and Figure 9c one week later. This case shows how effective the TAŞ Nasal Splint® technique is. Under normal circumstances, had classic splinting been used, the patient with a bleeding disorder would have bled from all dissection areas, the classic splint could not have prevented this and would have lifted, and, considering the osteotomy and grafting techniques used to correct such a crooked nose, all of these would have shifted and the operation would have been in vain. Thanks to the gentle, stable pressure of the TAŞ Nasal Splint®, this situation was overcome successfully.

1. a) The patient before surgery,

b) The patient on day 3 after surgery

1. c) The patient on day 7 after surgery

Figure 10: The patient's abdomen, where 5 cc of fat was aspirated, on day 7 after surgery
Figure 11 a-d: The patient before surgery and 7 days after. Despite von Willebrand disease that could not be detected before surgery, the result on day 7 is gratifying for both surgeon and patient.
Figure 12: A very large, humped male nose with thick, oily skin. It is well known that oedema in nasal surgery is greatest in patients with thick skin, and that the main causes of oedema and bruising are major procedures such as osteotomies and alar surgery. All of these factors were present in this patient: thick skin, extensive bony work and osteotomies, and bilateral alar surgery. Nevertheless, the result 7 days after surgery shows minimal oedema and no bruising, demonstrating the effect of the TAŞ Nasal Splint®.

1. a) The patient before surgery,

b) The patient on day 3 after surgery

1. c) The patient on day 7 after surgery

Figure 13 a-e: The patient before surgery and 7 days after.
Figure 14: A male patient with a 45-degree external deviation to the right and a completely blocked airway, needing major surgery. The operation was not cosmetic rhinoplasty but nasomaxillary surgery involving the entire midface. The good result before and 7 days after even such surgery reflects the effect of the TAŞ Nasal Splint®.
a-d) The patient before surgery and 7 days after.
Figure 15: A patient concerned about a low radix, a hump with supratip, a hanging columella, a drooping tip and a wide dorsum underwent radix augmentation, a supratip onlay graft, hump excision with spreader flap reconstruction, roof repair with medial and lateral osteotomies, and tip plasty. The images before surgery and 7 days after show no bruising and almost no oedema, demonstrating how successful the TAŞ Nasal Splint® is even in cases using so many structural and camouflage grafts.
a-g) The patient before surgery and 7 days after.