title: The efficacy of steroids for edema and ecchymosis after rhinoplasty: a meta-analysis.
abstract: OBJECTIVE
  Postoperative periorbital edema and ecchymosis following rhinoplasty can result in dissatisfaction for both the surgeon and the patient. The goal of this study was to perform a systematic review of the literature on the efficacy of steroids on edema and ecchymosis during rhinoplasty.
  
  
  METHODS
  MEDLINE, SCOPUS, and Cochrane database.
  
  
  METHODS
  Two authors independently searched the databases from their inception of article collection to February 2014. Studies comparing perioperative steroid administration (steroid group) with no treatment (control group) where the outcomes of interest were edema and ecchymosis on postoperative days were included in the analysis. Overall, a total of nine trials met the inclusion criteria of this study, with a total sample size of 312 patients.
  
  
  RESULTS
  The lower and upper eyelid edema during the 7 days postoperatively was statistically decreased in the steroid group versus control group. The lower and upper eyelid ecchymosis in the steroid group was significantly decreased in comparison to the control group for the first 4 days follow surgery. Regarding the outcome comparison between single-dose and multiple-dose administration of steroids, the multiple-dose administration decreased edema and ecchymosis significantly compared to single-dose administration after the fourth day.
  
  
  CONCLUSIONS
  Perioperative administration of steroid during rhinoplasty could reduce the level of edema and eyelid ecchymosis. Multiple-dose administration of steroids has more advantages in terms of the outcomes of late postoperative edema and ecchymosis compared to a single-dose regimen.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors.forename: Se H
authors.initials: SH
authors.lastname: Hwang
authors.forename: Joo H
authors.initials: JH
authors.lastname: Lee
authors.forename: Byung G
authors.initials: BG
authors.lastname: Kim
authors.forename: Soo W
authors.initials: SW
authors.lastname: Kim
authors.forename: Jun M
authors.initials: JM
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004438:Ecchymosis / Q000188:drug therapy*; D004487:Edema / Q000188:drug therapy*; D005141:Eyelid Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011183:Postoperative Complications / Q000188:drug therapy*; D019106:Postoperative Hemorrhage; D016032:Randomized Controlled Trials as Topic; D012225:Rhinoplasty / Q000009:adverse effects*
chemical_list: D000305:Adrenal Cortex Hormones; D003907:Dexamethasone; D001623:Betamethasone; D008775:Methylprednisolone
keywords: Rhinoplasty; ecchymosis; edema; steroids