Objective To determine the effi cacy of intravenous dexamethasone in reducing postrhinoplasty edema.Design A prospective, randomized clinical trial with placebo control.Setting Department of Otorhinolaryngology, Al-Sabah and Zain Hospital, Kuwait.Subject Eighty-four patients (male = 28; female = 56) aged between 20 and 40 years, undergoing open rhinoplasty with hump removal and bilateral lateral osteotomies were enrolled in this study.Intervention Patients were randomized to receive two doses of 10 mg of dexamethasone intravenously or placebo, fi rst dose during surgery and second dose 12 hours after surgery. Main outcome measuresPatients were evaluated postoperatively at 24 hours, days 2, 5, 7 and 10 for periorbital edema.Results 10 mg of dexamethasone given intravenously during rhinoplasty and a second dose 12 hours after surgery, reduced postoperative periorbital edema signifi cantly.Conclusion This study showed a statistically signifi cant benefi t of dexamethasone over placebo in reducing periorbital edema after rhinoplasty. No complications were attributed to the administration of dexamethasone.

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Sebaceoma is a benign tumor composed of incompletely differentiated sebaceous cells of varying degrees of maturity. Sebaceomas was never reported as a known premalignant lesion.This is a report of a sixteen year old boy who presented with a malignant transformation of a recurrent sebaceoma which was excised twice by Moh’s surgery. Excision was done with a free margin of 1 cm down to the parotid fascia. Reconstruction was performed on the same set by using cervicofascial flap extending down to the supra-clavicular area. The patient had an uneventful postoperative period apart from distal marginal necrosis of the flap, which healed nicely with conservative measures and daily dressing and was sent to our cancer centre to start his adjuvant radiotherapy.Previous literature stated that sebaceoma is a distinctive benign tumor. We have presented a case of an unusual malignant transformation of a preauricular recurrent sebaceoma. This indicates that sebaceoma does have a potential risk of malignant transformation. We believe that managing recurrent sebaceoma more aggressively with wide local excision and postoperative adjuvant radiotherapy would provide better prognosis.

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