Effect of Lateral Osteotomy in Subperiostal Plan in Reducing Severity of Periorbital Edema and Ecchymosis after Rhinoplasty

Introduction: Osteotomy is the main reason of periorbital edema and ecchymosis after rhinoplasty due to damage of angular vessels and fracture of the nasal bones and frontal process of maxilla. Several methods are suggested for reducing periorbital edema and ecchymosis. The main purpose of this study was to determine the effect of internal lateral osteotomy in subperiosteal plan in reducing periorbital edema and ecchymosis after rhinoplasty.

Methods: This double-blinded clinical trial was conducted on 30 patients. Internal lateral osteotomy was performed in one side in subperiosteal plan and opposite side used as a control without elevation of periostium from the bone. The degree of edema/ecchymosis on both sides was compared on the 1st and 7th day postoperatively.

Results: The severity of periorbital edema was more significant in one side with periosteal elevation 24 hours after operation (P. value=0.006). However, no significant difference was found in periorbital edema between both sides 7 days after the surgery (P. value=0.098). The severity of periorbital ecchymosis was also more significant in the side with periosteal elevation 24 hours (P. value= 0.023) and seven days after operation (P. value=0.004).

Conclusion: Since lateral osteotomy in subperiosteal plan increased periorbital edema and ecchymosis after rhinoplasty, performing lateral osteotomies without subperiosteal tunneling during rhinoplasty operation is suggested.