The effectiveness of steroids for edema, ecchymosis, and intraoperative bleeding in rhinoplasty

• Published in: American journal of rhinology & allergy Vol. 25; no. 2; pp. e95 - e98
• Main Authors: Koc, Sema, Gürbüzler, Levent, Yaman, Hüseyin, Eyibilen, Ahmet, Süren, Mustafa, Kaya, Ziya, Yelken, Kursat, Aladağ, Ibrahim
• Format: Journal Article
• Language: English
• Published: United States 01.03.2011
• Subjects: Adolescent; Adult; Blood Loss, Surgical - prevention & control; Disease Progression; Ecchymosis - drug therapy; Ecchymosis - etiology; Ecchymosis - physiopathology; Edema - drug therapy; Edema - etiology; Edema - physiopathology; Humans; Male; Methylprednisolone - administration & dosage; Methylprednisolone - adverse effects; Osteotomy - adverse effects; Postoperative Complications; Rhinoplasty - adverse effects; Severity of Illness Index; Treatment Outcome
• ISSN: 1945-8924; 1945-8932
• DOI: 10.2500/ajra.2011.25.3612

The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy. Forty patients were divided into three groups: those in group 1 (n = 15) were given a single dose of 1-mg/kg intravenous (i.v.) methylprednisolone, those in group 2 (n = 15) were given a single dose of 3-mg/kg i.v. methylprednisolone preoperatively, and group 3 (n = 10) was the control group. Eyelid edema and periorbital soft-tissue ecchymosis were evaluated separately using a scale of 0-4. In groups using the steroid preoperatively, periorbital edema and ecchymosis were significantly lower compared with the control group (p < 0.05). No significant differences were seen clinically or statistically in preventing or reducing either the periorbital ecchymosis or the periorbital edema between groups 1 and 2. Also, there was no significant difference among the groups in terms of bleeding (p > 0.05). No complications with regard to the operation or steroid use were observed. Our results support that steroids significantly decrease periorbital ecchymosis and periorbital edema in open rhinoplasty with osteotomy. Additionally, our results suggest that if the dose of steroids is adjusted according to body weight, there is no significant benefit in a single dose of 3 mg/kg of methylprednisolone over a lower dose of 1 mg/kg and there is no need for higher doses of methylprednisolone administration.