phenylephrine-hydrochloride and Ecchymosis

Nasal surgeries (such as Functional Endoscopic Sinus Surgery, Rhinoplasty, and Septorhinoplasty) are popular procedures. But perioperative bleeding, eyelid edema, and periorbital ecchymosis remain problems. Tranexamic acid (TXA) is an antifibrinolytic, and it was used to reduce the perioperative bleeding. However, there is no enough evidence judging its safety and efficiency. Therefore, a meta-analysis is conducted by us to evaluate the role of TXA in patients undergoing nasal surgeries.. A search of the literature was performed until June 2018; the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed. Only randomized controlled trial (RCT) articles were included, and subgroup analysis was established to deal with heterogeneity. RevMan 5.3 software was selected to conduct the meta-analysis.. Eleven RCTs were included in our meta-analysis. There were significant differences in blood loss (P < .001), surgical field quality (P < .001), edema rating of upper (P < .001) and lower (P < .001) eyelid, ecchymosis rating of upper (P < .001) and lower eyelid (P < .001) when comparing the TXA group to the placebo group. However, the difference in operation time (P = .57) was not significant between the two groups.. Perioperative TXA could reduce the blood loss and improve the quality of surgery field during nasal surgery, and it was helpful for reducing the edema and ecchymosis after nasal surgeries, but it has little influence in reducing the operation time.

Topics: Antifibrinolytic Agents; Blood Loss, Surgical; Ecchymosis; Edema; Eyelid Diseases; Humans; Nasal Surgical Procedures; Nose; Operative Time; Randomized Controlled Trials as Topic; Tranexamic Acid

Post-operative periorbital ecchymosis and edema following rhinoplasty is a well-known sequela of surgery. Unfortunately, this can be a source of distress for patients, resulting in a longer post-operative recovery time and a delayed return to work. Trauma caused by lateral osteotomies is likely the most significant cause of periorbital edema and ecchymosis in rhinoplasty. There have been various strategies proposed to minimize swelling and ecchymosis with varying success rates and accompanied risks. Intraoperative nasal compression is one potential strategy that may reduce post-operative edema and ecchymosis with minimal risk.. To determine whether applying direct lateral nasal pressure intraoperatively immediately after performing lateral osteotomies reduces visible post-operative edema and ecchymosis.. A prospective, randomized blinded study on consecutive patients undergoing rhinoplasty with lateral osteotomies was conducted in a single academic tertiary care medical center. Each of the participants were randomized into direct pressure application post-lateral osteotomies on the right or the left hand side. Intra-operatively, direct lateral nasal pressure was performed on the pre-determined side for 5 min timed by stopwatch after osteotomy. Post-operatively, standard photographs were taken of the patient on post-operative days 1, 3, and 7. These photographs were then shown to 20 blinded-physicians and the degree of ecchymosis and edema was graded using a previously published scale.. A total of 16 patients were included in this study. Based on our blinded-grading, 11 of the 16 patients had a clear global improvement in the degree of peri-orbital post-operative edema and ecchymosis with compression post lateral osteotomies. Based on the 3 blinded expert reviewers, Periorbital ecchymosis was significantly decreased on the ipsilateral side of pressure application in 10 of the 16 patients, and periorbital edema was significantly decreased in 13 of the 16 patients. The differential degree in periorbital ecchymosis was most pronounced on post-operative day 7. Patient factors such as gender, age, skin color, history of nasal trauma, side of pre-operative nasal deviation, and smoking status did not have a significant influence on the effect of pressure application post lateral osteotomies.. Application of direct continual lateral nasal pressure intraoperatively after performing lateral osteotomies can help reduce post-operative edema and ecchymosis up to post-operative day 7. This may lead to an overall improved appearance and subsequently an improved post-operative experience for the patient. Although the effect may be variable to some degree, this is an intervention with no additional risks involved and thus can be used in a safe manner.

Topics: Adult; Compression Bandages; Ecchymosis; Edema; Female; Humans; Intraoperative Care; Male; Middle Aged; Nose; Postoperative Complications; Pressure; Prospective Studies; Rhinoplasty; Young Adult

Background/aim: Periorbital edema and ecchymosis may develop following rhinoplasty. The aim of this study was to assess the efficacy of adhesive strip application on the upper and lower eyelids to reduce postoperative edema and ecchymosis following rhinoplasty. Materials and methods: The eyelids of one side were randomly selected, and an adhesive strip of standard size and number was applied at the end of the operation. The strips were removed at postoperative day 3; photos of the eyes were taken at days 3 and 7. Edema and ecchymosis were graded on a scale from 1 to 4. The ecchymosis areas on the lower and upper eyelids were measured and compared in square centimeters. Results: The mean ecchymosis area of the lower eyelid on the side of the adhesive strip and on the side without the strip was 1.63 cm2 and 3.32 cm2 in the early period, respectively. It was 1.15 cm2 on the upper eyelid on the side of the adhesive strip, and 1.87 cm2 on the side without the strip. It was 0.224 cm2 on the side of the adhesive strip, and 0.498 cm2 on the side without the adhesive strip in the late period. Conclusion: Applying adhesive strips reduces periorbital edema and ecchymosis.

Topics: Adhesives; Adolescent; Adult; Ecchymosis; Edema; Eyelids; Female; Humans; Male; Nose; Postoperative Complications; Rhinoplasty; Young Adult

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.. To determine the relationship between nasal skin thickness and postoperative periorbital ecchymosis and edema among patients who underwent rhinoplasty at King Abdulaziz University Hospital.. 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.. 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 (. 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.

Topics: Adult; Ecchymosis; Edema; Female; Humans; Male; Nose; Postoperative Complications; Postoperative Period; Predictive Value of Tests; Prognosis; Prospective Studies; Rhinoplasty; Skin; Skinfold Thickness; Treatment Outcome; Young Adult

Understanding the postoperative dynamics of the nasal soft-tissue envelope (NSTE) is necessary to obtain the desired cosmetic results after rhinoplasty. This study was conducted to determine the changes of NSTE thickness and its effects on periorbital edema and ecchymosis following rhinoplasty.. Thirty-five patients who underwent rhinoplasty were included in the study. Nasal skin and subcutaneous tissue thickness at the tip, supratip, rhinion, and nasion were measured using ultrasonography preoperatively and at the postoperative 3rd and 10th months. Periorbital edema and ecchymosis were evaluated at postoperative days 1, 3, and 7. The patients were categorized as the thick NSTE group (n = 17) and the thin NSTE group (n = 18) according to the preoperative median NSTE thickness.. In the thin NSTE group, supratip skin, subcutaneous tissue, and total NSTE thickness were lowest on the preoperative day but no statistically significant difference was found for the thick NSTE group. In the thin NSTE group, total NSTE thickness of the rhinion was highest at the postoperative 3rd month, but in the thick NSTE group, there was no statistically significant difference between postoperative 3rd and 10th months. In both groups, total NSTE thickness of the nasion was highest at the postoperative 3rd month and lowest at the postoperative 10th month.. Supratip fullness occurs more prominent in patients with thin NSTE. Postoperative edema in the rhinion is greater in patients with thin NSTE for the early postoperative period but it lasts longer in patients with thick NSTE. Soft-tissue envelope atrophy at the nasion occurs in both groups in the late postoperative period. Periorbital edema and ecchymosis severity are not affected by NSTE thickness.

Topics: Ecchymosis; Edema; Humans; Nose; Postoperative Complications; Postoperative Period; Rhinoplasty; Ultrasonography

Rhinoplasty is one of the most commonly performed aesthetic procedures today. Although nasal airway obstruction is frequently treated concomitantly with the aesthetic procedure, chronic sinusitis has typically postponed until full resolution of inflammatory symptoms.. To investigate the feasibility of combining FESS with septorhinoplasty by measuring different outcomes including operative time, blood loss, post-operative edema of the upper and lower eyelids, periorbital ecchymosis, patient discomfort and complication rates.. The study included 20 patients with deformed nose associated with chronic rhinosinusitis (CRS) not responding to medical treatment for at least 3 continuous months, irrespective to sex, of ages 20-60, and without any systemic diseases (study group), and 20 patients with deformed nose without any sinus problems (control group).. There was no significant difference between the two groups in the different measured outcomes (P>0.05) except for the operative time which was significantly less in the control group (P<0.05).. Concurrent rhinoplasty and endoscopic sinus surgery may be performed safely and effectively with minimal risks. Proper patient selection and sound intraoperative judgment can avoid potential complications.

Topics: Adult; Case-Control Studies; Ecchymosis; Edema; Endoscopy; Eyelid Diseases; Feasibility Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasal Cavity; Nose; Operative Time; Patient Satisfaction; Postoperative Complications; Prospective Studies; Rhinitis; Rhinoplasty; Sinusitis; Young Adult

Topics: Accidents, Traffic; Alcoholic Intoxication; Anesthesia, Local; Cerebrospinal Fluid Rhinorrhea; Child; Contusions; Ecchymosis; Edema; Epistaxis; Frontal Bone; Hematoma; Humans; Nasal Bone; Nasal Septum; Nose; Orbital Fractures; Skull Fractures; Violence

A mixture of epinephrine and hyaluronidase, injected into the naso-orbital recess at the start of dacryocystorhinostomy and into the nasal mucosa immediately after bone penetration, appears to have a greater hemostatic effect than epinephrine alone. Surgical time is shortened by the reduced need for angular vessel ligation, suction, cautery of bleeding, and nasal packing. Postoperative ecchymosis and nasal clotting are also reduced.

Topics: Drainage; Drug Combinations; Ecchymosis; Epinephrine; Hemostasis; Humans; Hyaluronoglucosaminidase; Injections; Lacrimal Apparatus; Nasal Cavity; Nose; Postoperative Complications

Topics: Carica; Drug Therapy; Ecchymosis; Edema; Humans; Nose; Papain; Peptide Hydrolases; Postoperative Complications; Rhinoplasty; Surgery, Plastic

Topics: Adrenochrome; Ecchymosis; Humans; Nose; Postoperative Period; Sodium Salicylate