Steroids and Rhinoplasty: A Double-blind Study

Hoffmann, Dieter; Cook, Ted A.; Quatela, Vito C.; Wang, Tom D.; Brownrigg, Peter J.; Brummett, Robert E.; Simons, Robert L.

doi:10.1001/archotol.1991.01870210066010

Cited by 16 publications

(33 citation statements)

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“…Hoffmann et al [13] used dexamethasone intraoperatively and gave additional tapering doses for 5 days. They reported that swelling and ecchymosis were reduced for up to 7 days after rhinoplasty.…”

Section: Methodsmentioning

confidence: 99%

Results of intravenous steroid injection on reduction of postoperative edema in rhinoplasty

Alajmi

Al-Abdulhadi

Al-noumas

et al. 2009

Indian J Otolaryngol Head Neck Surg

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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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Section: Methodsmentioning

confidence: 99%

Results of intravenous steroid injection on reduction of postoperative edema in rhinoplasty

Alajmi

Al-Abdulhadi

Al-noumas

et al. 2009

Indian J Otolaryngol Head Neck Surg

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“…34 reported a patient who experienced gastrointestinal bleeding after receiving steroids for 5 days. However, a single dose of Glucocorticoid, even a large one, can be used without a harmful effect.…”

Section: Discussionmentioning

confidence: 99%

Role of Corticosteroids in Reduction of Post-Operative Oedema in Craniofaciomaxillary Surgery

Malhari¹,

Sharma²,

Rattan³

2016

jemds

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Postoperative oedema and ecchymosis are common complaints following facial plastic surgical procedures. The resulting oedema and ecchymosis is socially disturbing and sometimes frightening for the patient. Serious consequences of oedema include airway obstruction, conjunctival chemosis with possible transient loss of vision and pain. Perioperative administration of steroids has been used in Craniofaciomaxillary procedures with a belief that it reduces postoperative swelling and shortens time to recovery after surgery. Various perioperative regimens of systemic corticosteroid administration have been reported to result in a significant reduction in postoperative facial oedema following cranioplasty, orbital floor exploration, mandibular and maxillary osteotomy, facial plasty, hair transplant and rhinoplasty. A number of experimental animal studies have demonstrated decreased oedema in flap models or replants. However, several clinical studies evaluating the use of steroids perioperatively in a variety of orthognathic and facial surgical procedures have failed to provide concrete evidence for or against steroid usage. Proponents of steroid use (Nordstrom et al, Flood et al and Gurlek et al) claim, it decreases postoperative oedema, decreases ecchymosis, improves surgical outcome, reduces home convalescence, decreases hospital stay and causes euphoria. Opponents of steroid use (Munro et al, Rapaport et al, and Owsley et al) claim lack of evidence, serious complications like inhibition of Hypothalamic Pituitary-Adrenal axis, avascular necrosis of hip and humerus, alter blood sugar levels, increased risk of hypertension, increase in the incidence of wound infection and lack of cost effectiveness. A prospective double-blind study conducted to evaluate the role of Dexamethasone 8 mg intravenous administration and Triamcinolone 0.7 mg/kg administration at the end of procedure in reduction of postoperative facial oedema in Craniofaciomaxillary surgeries. Thirty-four consecutive patients were randomized to Dexamethasone, Triamcinolone administration and control group. Facial size was measured on POD1, POD2 and POD3. Facial oedema scores were derived from comparison of photographs on admission and 48 hrs. postoperatively. Findings were tabulated and statistically analysed. Following observations were noted. The duration of surgery and postoperative facial oedema did not correlate. We found that oedema was maximum in the periorbital region in all the three groups followed by oedema on forehead, malar and mandibular regions. We also observed that there was direct correlation between forehead and periorbital oedema. We observed that there was postoperative facial oedema on POD1, reached its peak on POD2 and then started declining within each group. The use of steroids either intravenous (8 mg Dexamethasone) or local infiltration (Triamcinolone 0.7 mg/kg) did not significantly reduce the postoperative facial oedema in our patient when compared to the control.

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“…Most reports present isolated findings of one type of steroid compared with placebo; two studies, however, have reported conflicting results. In 1991, Hoffman et al (18) reported findings using a combination of steroids, with an initial 10 mg dose of dexamethasone before surgery and complementary oral prednisolone doses that started at 50 mg and were tapered by 10 mg each day. Their results appear to be somewhat biased by the fact that their patients were allowed to use ibuprofen as needed in both arms of the study, without standardization of the dose.…”

Section: Discussionmentioning

confidence: 99%

Testing the effects of long-acting steroids in edema and ecchymosis after closed rhinoplasty

Gutiérrez¹,

Wuesthoff²

2014

CAN J PLAST SURG

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Steroids and Rhinoplasty: A Double-blind Study

Cited by 16 publications

References 0 publications

Results of intravenous steroid injection on reduction of postoperative edema in rhinoplasty

Results of intravenous steroid injection on reduction of postoperative edema in rhinoplasty

Role of Corticosteroids in Reduction of Post-Operative Oedema in Craniofaciomaxillary Surgery

Testing the effects of long-acting steroids in edema and ecchymosis after closed rhinoplasty

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