Effects of Steroids on Edema and Ecchymosis in Rhinoplasty

A randomized, prospective double-blind study with placebo control was planned to determine the effects of a single-dose dexamethasone in reducing postoperative edema and ecchymosis after rhinoplasty. Fifty-six consecutive patients who underwent rhinoplasty with hump removal and lateral osteotomies were enrolled in this study. Thirty patients received 10 mg of dexamethasone intravenously before surgery and twenty-six patients received placebo. Postoperative scoring of edema and ecchymosis was begun approximately 24 hours after surgery. All patients were operated by the authors. A 4-point scale was used to assess the extent of periorbital edema and ecchymosis 24 hours postoperatively. A single-dose of 10 mg of dexamethasone intravenously reduced postoperative edema and ecchymosis significantly. The first two days differences between the steroid and placebo groups for edema and ecchymosis were clinically and statistically significant (p < 0.05). This study showed a statistically significant benefit of steroids when compared to placebo in decreasing edema and ecchymosis in rhinoplasty. However, the effect of dexamethasone has disappeared after the first two days, and its use did not shorten the recovery. No complications were attributed to the administration of dexamethasone.