Effect of the Rhinoplasty Technique and Lateral Osteotomy on Periorbital Edema and Ecchymosis

Kılıç, Caner; Tuncel, Ümit; Cömert, Ela; Şencan, Ziya

doi:10.1097/scs.0000000000001885

Cited by 19 publications

(17 citation statements)

References 20 publications

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“…6,7 The extent of edema and ecchymosis after rhinoplasty also depends upon other factors such as the presence of any coagulation disorders, undue subcutaneous fat, the type of surgical procedure carried out, the type of osteotomy, the location differences of the arteria angularis, and any drug use prior to surgery. 8 The application of a diverse range of surgical techniques also influences the postoperative edema and ecchymosis rates of rhinoplasty. Every modus operandi has unique advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Is Nasal Skin Thickness a Prognostic Indicator to Postoperative Edema and Ecchymosis?

Aldosari

2019

Ear Nose Throat J

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Background: The size, shape, and symmetry of the nose contribute significantly to the facial aesthetic, so it is understandable why rhinoplasty is one of the most popular cosmetic procedures undertaken nowadays. Several factors are associated with the rates of both success and postoperative complications of rhinoplasty. Aim: To determine the relationship between nasal skin thickness and postoperative periorbital ecchymosis and edema among patients who underwent rhinoplasty at King Abdulaziz University Hospital. Methodology: A prospective study was conducted among all patients operated on for rhinoplasty at King Abdulaziz University Hospital in the Department of Otolaryngology, Riyadh, Saudi Arabia, between May and December 2018. To determine the relationship between nasal skin thickness and postoperative periorbital edema and ecchymosis, demographic data (gender, age), mean nasal skin thickness, surgical factors (time of surgery, extent of intraoperative bleeding), and scoring for periorbital ecchymosis and edema were obtained. The statistical analysis was done by comparing means and frequency using analysis of variance. Results: A total of 54 patients participated in this study with ages ranging from 19 to 33 years and a mean age of 24.43. According to this study, postoperative edema presentation on the first, third, and seventh days upon examination was higher among patients with thicker nasal skin (6 mm), and results are statistically significant ( P = .001). Ecchymosis was also higher among patients with thicker nasal skin (6 mm) on day 1 examinations, but there was no correlation with nasal thickness during the other examinations. Therefore, there is some degree of correlation between ecchymosis and nasal skin thickness overall, but the results are not significant ( P = .26). Conclusion: This study concludes that the severity of edema and ecchymosis correlates with nasal skin thickness. The degree of edema and ecchymosis was higher during the initial postoperative examinations, but following that, it was reduced and completely diminished by the 21st day post-surgery.

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Section: Introductionmentioning

confidence: 99%

Is Nasal Skin Thickness a Prognostic Indicator to Postoperative Edema and Ecchymosis?

Aldosari

2019

Ear Nose Throat J

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“…approaches) as well as dissection technique. 2 Currently, there are no validated grading systems to measure periorbital edema and ecchymosis, leading to inconsistent reporting in the medical literature.…”

mentioning

confidence: 99%

Validation of the Modified Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) Questionnaire: A Prospective Analysis of Facial Plastic and Reconstructive Surgery Procedures

et al. 2018

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Although periorbital edema and ecchymosis are commonly encountered after facial plastic and reconstructive surgery procedures, there is currently no validated grading scale to qualify these findings. In this study, the modified "Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE)" questionnaire is used as a grading scale for patients undergoing facial plastic surgery procedures. This article aims to validate a uniform grading scale for periorbital edema and ecchymosis using the modified SPREE questionnaire in the postoperative period. This is a prospective study including 82 patients at two different routine postoperative visits (second and seventh postoperative days), wherein the staff and resident physicians, physician assistants (PAs), patients, and any accompanying adults were asked to use the modified SPREE questionnaire to score edema and ecchymosis of each eye of the patient who had undergone a plastic surgery procedure. Interrater and intrarater agreements were then examined. Cohen's kappa coefficient was calculated to measure intrarater and interrater agreement between health care professionals (staff physicians and resident physicians); staff physicians and PAs; and staff physicians, patients, and accompanying adults. Good to excellent agreement was identified between staff physicians and resident physicians as well as between staff physicians and PAs. There was, however, poor agreement between staff physicians, patients, and accompanying adults. In addition, excellent agreement was found for intraobserver reliability during same-day visits. The modified SPREE questionnaire is a validated grading system for use by health care professionals to reliably rate periorbital edema and ecchymosis in the postoperative period. Validation of the modified SPREE questionnaire may improve ubiquity in medical literature reporting and related outcomes reporting in future.

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“…34 Significantly less swelling and bruising were seen after continuous endonasal lateral osteotomy in the endonasal approach as compared with the external approach. 35 Also, postoperative first-day edema and postoperative seventh-day ecchymosis scores were significantly better in the patients who had been operated through an endonasal approach as opposed to an external approach with the lateral osteotomy in both groups being an external perforating osteotomy. 35 The authors conclude that the endonasal approach should be preferred whenever feasible, but the choice of the osteotomy technique should be based on the surgeon's preference since it had no influence on edema and hematoma formation.…”

Section: Choice Of the Osteotome And Osteotomy Techniquementioning

confidence: 81%

“…35 Also, postoperative first-day edema and postoperative seventh-day ecchymosis scores were significantly better in the patients who had been operated through an endonasal approach as opposed to an external approach with the lateral osteotomy in both groups being an external perforating osteotomy. 35 The authors conclude that the endonasal approach should be preferred whenever feasible, but the choice of the osteotomy technique should be based on the surgeon's preference since it had no influence on edema and hematoma formation. A study measuring the resolution of swelling after a percutaneous lateral osteotomy on one side and an endonasal osteotomy on the other side with 3D stereophotogrammetry found no difference between the sides.…”

Section: Choice Of the Osteotome And Osteotomy Techniquementioning

confidence: 81%

Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach

Tasman

2018

Facial plast Surg

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Postoperative periorbital edema and ecchymosis are most bothersome to rhinoplasty patients. The degree of swelling and bruising is influenced by several factors, and numerous prophylactic and therapeutic measures have been described in the literature. This article reviews the current literature and concludes with the author's suggestions on how to best minimize postoperative periorbital edema and ecchymosis.

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Effect of the Rhinoplasty Technique and Lateral Osteotomy on Periorbital Edema and Ecchymosis

Cited by 19 publications

References 20 publications

Is Nasal Skin Thickness a Prognostic Indicator to Postoperative Edema and Ecchymosis?

Is Nasal Skin Thickness a Prognostic Indicator to Postoperative Edema and Ecchymosis?

Validation of the Modified Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) Questionnaire: A Prospective Analysis of Facial Plastic and Reconstructive Surgery Procedures

Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach

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