title: Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty?
abstract: OBJECTIVE
  The study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative periorbital edema, ecchymosis, and subconjunctival ecchymosis.
  
  
  METHODS
  Eighteen consecutive patients who underwent septorhinoplasty were included in the study. In all patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The patients were seen on the second postoperative day, and a different surgeon who was unaware of the side with the periosteal tunnel determined the side of the face with more edema and ecchymosis. Subconjunctival ecchymosis was evaluated and recorded, as well.
  
  
  RESULTS
  Creating subperiosteal tunnels before lateral osteotomy statistically increased periorbital ecchymosis. Although there was no statistically significant difference, creating subperiosteal tunnels also increased development and severity of subconjunctival ecchymosis and edema.
  
  
  CONCLUSIONS
  We suggest performing lateral osteotomy without creating subperiosteal tunnels.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey. cokara@yahoo.com
authors.forename: Cüneyt Orhan
authors.initials: CO
authors.lastname: Kara
authors.forename: Inci Gökalan
authors.initials: IG
authors.lastname: Kara
authors.forename: Bülent
authors.initials: B
authors.lastname: Topuz
mesh_terms: D000293:Adolescent; D000328:Adult; D003229:Conjunctival Diseases / Q000517:prevention & control; D004438:Ecchymosis / Q000517:prevention & control*; D004487:Edema / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D009916:Orbital Diseases / Q000517:prevention & control*; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods; D010521:Periosteum / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D016037:Single-Blind Method