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

Sakallioğlu, Öner MD*; Polat, Cahit MD*; Soylu, Erkan MD; Düzer, Sertaç MD*; Orhan, İsrafil MD; Akyiğit, Abdulvahap MD*

doi: 10.1097/SAP.0b013e3182a1e527
Aesthetic Surgery

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.

From the *Otorhinolaryngology Clinic, Elazığ Training and Research Hospital, Elazığ; and †Otorhinolaryngology Department, Medipol University Hospital, Istanbul, Turkey.

Received February 13, 2013, and accepted for publication, after revision, June 21, 2013.

Conflicts of interest and sources of funding: None declared.

Reprints: Öner Sakallioğlu, MD, Otorhinolaryngology Clinic, Elazığ Training and Research Hospital, Elazığ, Turkey. E-mail:

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