The efficacy of steroids for edema and ecchymosis after Rhinoplasty: A meta‐analysis

Hwang, Se Hwan; Lee, Joo H.; Kim, Byung Gon; Kim, Soo W.; Kang, Jun Myung

doi:10.1002/lary.24883

Cited by 43 publications

(42 citation statements)

References 23 publications

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“…Repeated doses were found to be more effective than a single-dose steroid regimen. 8 Gun et al investigated the effects of combination of lidocaine and adrenalin injections on postoperative edema and ecchymosis. 9 They concluded that the application of a combination of lidocaine and adrenalin may reduce bleeding during rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty

Şimşek

Sarı

Kılıç

et al. 2016

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty

Şimşek

Sarı

Kılıç

et al. 2016

Plastic and Reconstructive Surgery

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“…Kargı et al demonstrated that preoperative and intraoperative (as well as on postoperative days 1 and 2) intravenous administration of dexamethasone of 8 mg reduced edema and ecchymosis (2). Studies show that preoperative administration of steroids reduced edema and ecchymosis, and repeated administration of steroids was more effective than administration of a single dose (5,14). A study performed by Koşucu et al reported that keeping intraoperative mean arterial blood pressure at 50-60 mmHg reduced edema and ecchymosis (15).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of adhesive strips to reduce postoperative periorbitaledema and ecchymosis following rhinoplasty

Tatar¹,

Bulam²,

Özmen³

2018

Turk J Med Sci

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Background/aim: Periorbital edema and ecchymosis may develop following rhinoplasty. The aim of this study was to assess the efficacy of adhesive strip application on the upper and lower eyelids to reduce postoperative edema and ecchymosis following rhinoplasty. Materials and methods: The eyelids of one side were randomly selected, and an adhesive strip of standard size and number was applied at the end of the operation. The strips were removed at postoperative day 3; photos of the eyes were taken at days 3 and 7. Edema and ecchymosis were graded on a scale from 1 to 4. The ecchymosis areas on the lower and upper eyelids were measured and compared in square centimeters. Results: The mean ecchymosis area of the lower eyelid on the side of the adhesive strip and on the side without the strip was 1.63 cm2 and 3.32 cm2 in the early period, respectively. It was 1.15 cm2 on the upper eyelid on the side of the adhesive strip, and 1.87 cm2 on the side without the strip. It was 0.224 cm2 on the side of the adhesive strip, and 0.498 cm2 on the side without the adhesive strip in the late period. Conclusion: Applying adhesive strips reduces periorbital edema and ecchymosis.

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“…Many technical measures can be instituted to decrease the incidence and severity of post-operative edema and ecchymosis; these include the use of sharp small osteotomes [12, 14], preservation of the periosteal attachment [7], cold compresses [10], and the possible use of a looped drainage tube [15]. In addition, administration of perioperative steroids [9, 16] and remifentanil with controlled hypotension may further contribute to lessen periorbital edema and ecchymosis [17]. Ineffective measures, despite being widely practiced, include infiltration with lidocaine-adrenaline combination [1, 18] and administration of arnica [11].…”

Section: Discussionmentioning

confidence: 99%

The use of nasal packing post rhinoplasty: Does it increase periorbital ecchymosis? A prospective study

Arfaj

2015

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundPeriorbital edema and ecchymosis following rhinoplasty is disturbing for both the patients and their surgeons. The study aim was to determine whether nasal packing after lateral osteotomies in rhinoplasty surgery increases the risk of periorbital ecchymosis post-operatively.MethodsThis was a prospective self-controlled single-blinded study. Seventy four patients who underwent rhinoplasty with bilateral lateral osteotomies by a single surgeon were enrolled in the study. Nasal cavity packing for one side was done while the other side was left unpacked. Periorbital ecchymosis was evaluated by the operating surgeon and a separate surgeon who is unaware of the packing side separately on the first, fourth and seventh day post-operatively. A 4-grade scale was utilized to assess the ecchymosis with grade 4 being the most severe.ResultsNasal packing was found to significantly increase the severity and duration of periorbital ecchymosis post rhinoplasty. While no difference was observed between the packed and unpacked sides on the first post-operative day, significant difference was noted on the 4th day (mean score 2.36 and 1.15 for the packed and unpacked sides, respectively) and on the 7th day after surgery in favor of the unpacked side (score 1.24 and 0.61 for the packed and unpacked sides, respectively).ConclusionWe advise against the routine use of nasal packing in rhinoplasty unless necessary as it contributes to worsen the periorbital ecchymosis from lateral osteotomies and thereby increases the patients’ “down time” after surgery.

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The efficacy of steroids for edema and ecchymosis after Rhinoplasty: A meta‐analysis

Abstract: Perioperative administration of steroid during rhinoplasty could reduce the level of edema and eyelid ecchymosis. Multiple-dose administration of steroids has more advantages in terms of the outcomes of late postoperative edema and ecchymosis compared to a single-dose regimen.

Cited by 43 publications

References 23 publications

Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty

Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty

Efficacy of adhesive strips to reduce postoperative periorbitaledema and ecchymosis following rhinoplasty

The use of nasal packing post rhinoplasty: Does it increase periorbital ecchymosis? A prospective study

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