Which Type of Osteotomy for Edema and Ecchymosis

Abstract

External and internal techniques of osteotomy almost give the same results regarding edema and ecchymosis, but the internal continuous technique shows a tendency to produce less ecchymosis on the second postoperative day.

External vs. internal osteotomy in rhinoplasty

“…Only 4 patients had grade 2 edema and 16 patients had grade 1 edema and no ecchymosis to any of the patients. It has also been found that steroids reduce the edema and ecchymosis only on the first day of the surgery and did not have the effect on the following day (5) however Yucel (8) in his study of external or internal osteotomy found the edema score same in the both groups on second and seventh day of the surgery and the ecchymosis score also the same between two groups on the seventh day. He found external and internal technique of osteotomy almost give the same results regarding edema and ecchymosis but internal continuous technique shows a tendency to produce less ecchymosis on second postoperative day.…”

Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty

“…The suggestion that LAC injection reduces postoperative edema and ecchymosis is not based on any objective study. KARA et al and YUCEL did not provide any information regarding the effect of intraoperative bleeding and blood pressure on edema/ecchymosis 11,25 . Although KARGI et al and KARA et al reported that they measured intraoperative bleeding, they did not define a particular evaluation method 10,12 .…”

“…There is no information in the literature about the effects of median osteotomy on the extent of edema/ecchymosis [10][11][12]25 . LAC injection was not applied before median osteotomy in the authors' operations so as not to affect the degree of edema/ecchymosis.…”

“…YUCEL has compared the effect of external and internal osteotomy on edema and ecchymosis. He has observed that the external osteotomy technique causes less edema and ecchymosis postoperatively 25 . Both of these studies used the LAC preparation, but none of these researchers have made any suggestions regarding the effect of LAC on edema/ ecchymosis.…”

“…Other authors have suggested that creation of a subperiosteal tunnel due to periosteal elevation lifts the vessels above the osteotomy plane 8,16,19 . Some studies have suggested that lidocaine and adrenaline combination (LAC) injection be performed prior to osteotomy, regardless of whether local or general anaesthesia is used 10,11,25 . As described above, it has been suggested that LAC injection reduces the extent of postoperative edema and ecchymosis, but many factors contributed to formation of the edema and ecchymosis.…”