A double-blind, randomized trial with placebo control was planned to evaluate the effects of corticosteroids (betamethasone, dexamethasone, methylprednisolone) in approximately equivalent doses (8 mg dexamethasone/day), and to compare their effects with that of tenoxicam, an antiinflammatory drug, on both the edema and ecchymosis in open rhinoplasty with osteotomies. For this study, 40 patients were divided randomly into five groups of 8 patients each, which received, respectively, betamethasone (group 1), dexamethasone (group 2), methylprednisolone (group 3), tenoxicam (group 4), and placebo (group 5). Open rhinoplasty with osteotomies was performed by the same surgeon with the patient under general anesthesia. Drugs were administered just before the induction of anesthesia and continued for 3 days. Only acetaminophen was used to control postoperative analgesia. Digital photographs of each patient were taken on postoperative days 1, 3, and 7. Scoring was performed separately for eyelid swelling and ecchymosis by three observers independently using a graded scale from 0 to 4. No statistically significant differences existed among the five groups in terms of age, sex, duration of surgery, amount of bleeding, and intravenous fluid administration during the surgery. On postoperative days 1, 3, and 7, no differences in the levels of ecchymosis or edema among the steroid groups, the tenoxicam group, and the control groups were observed. In conclusion, the authors observed no significant differences among the different kinds of steroids administered in equivalent doses (8 mg dexamethasone/day). Steroids used in these doses were not effective in preventing or reducing edema and ecchymosis after open rhinoplasty with osteotomies. Tenoxicam also was not effective. No complications caused by the use of steroids were observed during the 6-month follow-up period.
Corticosteroids Ecchymosis Edema Nonsteroidal antiinflammatory drug Rhinoplasty
This is a preview of subscription content, log in to check access.
Amin MM, Engel MB, Laskin DM: Effect of indomethacin on postsurgical edema in rats. Oral Surg Oral Med Oral Pathol 55:244–246, 1983CrossRefPubMedGoogle Scholar
Assimes TL, Lessard ML: The use of perioperative corticosteroids in craniomaxillofacial surgery. Plast Reconstr Surg 103:313–322, 1999PubMedGoogle Scholar
Beirne OR, Hollander B: The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. Oral Surg Oral Med Oral Pathol 61:134–138, 1986CrossRefPubMedGoogle Scholar
Berinstein TH, Bane SM, Cupp CL, DeMarco JK, Hunsaker DH: Steroid use in rhinoplasty: An objective assessment of postoperative edema. Ear Nose Throat J 77:40–43, 1998PubMedGoogle Scholar