The Efficacy of Tranexamic Acid and Corticosteroid on Edema and Ecchymosis in Septorhinoplasty

Abstract

The aim of this study was to investigate the efficacy of tranexamic acid (TA) and methylprednisolone on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open septorhinoplasty (oSRP). Seventy-five patients performing hump extraction and osteotomies were allocated into 3 groups as follows: group 1, 25 patients as control; group 2, 25 patients who were administered oral TA as first dose 1 g starting 2 hours before surgery, 3 g daily in divided doses (1 g, every 8 hours) for 5 days; and group 3, 25 patients who were administered a single dose of 1 mg/kg intravenous methylprednisolone at the beginning of the surgery. Operation time, amount of intraoperative bleeding, and complications were recorded. Scoring of eyelid edema and periorbital ecchymosis was evaluated on postoperative first, third, and seventh days using scale of 0 to 4 by 2 observers. In groups using TA and methylprednisolone, periorbital edema and ecchymosis scores were significantly lower compared with the control group (P < 0.05). No significant difference was seen clinically and statistically in preventing or decreasing both periorbital edema and ecchymosis between group 2 and group 3. Patients given TA showed significantly less intraoperative bleeding compared with controls and patients who were administered methylprednisolone. We observed that the administration of methylprednisolone significantly decreases periorbital edema and ecchymosis. Additionally, our results support that TA use in patients who underwent oSRP with osteotomies was found clinically and statistically effective for prevention of bleeding during oSRP operations and reduction of both periorbital edema and ecchymosis.

Role of tranexamic acid in nasal surgery

“…Risk of bias is represented in Figures 2 and 3. Seven studies [15,16,18,20–23] were for FESS, 3 studies [13,14,17] were for rhinoplasty, and 1 study [19] was for septorhinoplasty. There were 7 articles had been published in recent 3 years, and the longest article included was published in 2006.…”

“…Three studies [13,14,19] provided the data of edema and ecchymosis rating of upper and lower eyelid, two of them were rhinoplasty and one is about septorhinoplasty. The same evaluation index of eyelid edema and ecchymosis used in the three literatures (Fig.…”

The effect of periorbital cooling on pain, edema and ecchymosis after rhinoplasty: a randomized, controlled, observer-blinded study

“…Regarding the mechanism of edema and eccyhmosis, the effect of local heparinoids was assessed in a study but it was not found effective in the prevention after rhinoplasty (19) . A recent study revealed the beneficial effects of tranexamic acid and corticosteroid combination in septorhinoplasty (20) .…”

Rhinoplasty without nasal packing and splinting

“…This is in correlation with the results of many other authors 38,[41][42][43][44][45][46][47][48][49][50][51] . We suggest that corticosteroid therapy and the use of lidocaine in prevention of the edema and ecchymosis in rhinoplasty 46,48,52 are not necessary, when using this technique of rhinoplasty.…”