Continuous Mild Cryotherapy with the Hilotherm System Versus Conventional Ice-Pack Therapy After Maxillofacial Trauma Surgery

Postoperative pain and facial edema are common sequelae following surgical management of maxillofacial trauma and may negatively affect early recovery and patient experience. Conventional ice packs provide intermittent and poorly controlled cooling at very low temperatures, with variable effectiveness and tolerability. Continuous mild cryotherapy delivered at a controlled temperature through a water-circulating facial mask may offer more consistent early postoperative benefits. We conducted a single-center retrospective cohort study including 240 adult patients who underwent surgical treatment for maxillofacial fractures. From October 2023 to January 2025, 120 consecutive patients received continuous temperature-controlled cryotherapy using the Hilotherm facial mask for the first 48 postoperative hours (Group A). A historical cohort of 120 patients treated with conventional ice-pack therapy during the preceding 12 months served as controls (Group B). The primary outcome was postoperative pain assessed at 24, 48, and 72 hours using a 0–4 faces pain scale. Secondary outcomes included facial edema assessed with the Modified Facial Swelling Scale (MFSS) on postoperative days 2 and 7, and patient-reported experience (comfort, ease of use, tolerance, and overall satisfaction) collected at 48 hours using a standardized questionnaire. Intergroup comparisons were performed using non-parametric tests, with effect sizes reported. Multivariable ordinal logistic regression was used to adjust for potential confounders. Patients treated with continuous cryotherapy reported significantly lower median pain scores at 24 hours (median 1 vs 2; P = 0.028) and 48 hours (median 1 vs 2; P = 0.036), with no significant difference at 72 hours. Facial edema assessed by MFSS was significantly reduced in the Hilotherm group on postoperative day 2 (P = 0.012), whereas scores were comparable between groups by day 7. Patient-reported comfort, tolerance, and overall satisfaction were significantly higher in Group A (all P ≤ 0.014), while ease of use was rated slightly higher in the ice-pack group. On multivariable analysis, use of the Hilotherm system remained independently associated with lower postoperative pain at 24 hours (adjusted OR 0.54; 95% CI 0.32–0.90). Compared with conventional ice-pack therapy, continuous controlled cryotherapy delivered via the Hilotherm system is associated with clinically meaningful reductions in early postoperative pain and facial edema and with improved patient comfort following maxillofacial trauma surgery. These benefits are confined to the acute postoperative phase but support the use of temperature-controlled cryotherapy as a valuable adjunct to standard postoperative care.