title: The effect of periorbital cooling on pain, edema and ecchymosis after rhinoplasty: a randomized, controlled, observer-blinded study.
abstract: Success and satisfactory results in rhinoplasty are established not only with flawless surgery but also with meticulous perioperative care. Pain stays at the centre of these circumstances. Besides, several contributing perioperative factors such as periorbital edema and ecchymosis play key role on the patients' comfort.
  
  
  
  Septorhinoplasty was carried out in 50 patients between February and May 2014 under general anesthesia. Local anesthesia with lidocaine and adrenaline combination was done prior to incision. Following the procedure, silicone gel packs were applied. One periorbital region was cooled after surgery whereas the opposite site was left uncooled. Periorbital edema-ecchmosis and pain intensity were graded and noted 1 hour, 1 day, 3 days, 1 week and 1 month after surgery.
  
  
  
  Cold application seriously reduced postoperative edema and ecchymosis at the first week (p=0.001 for the first 3 days and p=0.006 at first week). Pain was reduced with cooling not on the first hour (p&gt;0.05), but on the forthcoming days throughout the first week (p<0.005). Operation time revealed that primary cases were carried out quicker than revisional surgery. Moreover, pain scores were found lower in primary cases than revisions, especially in the first 3 days. These finding were approved statistically.
  
  
  
  Cooling of the periorbital region reduces edema and ecchymosis as well as pain; however 3 days of use is enough after rhinoplasty. One hour after surgery, cooling does not affect the pain but reduce edema and ecchymosis.
authors.affiliation: MS Baltalimani Bone D. Training and Research Hospital, Department of Plastic and Reconstructive Surgery, Istanbul, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Kayiran
authors.affiliation: Ekol ENT Hospital, Department of Ear, Nose and Throat, Izmir, Turkey.
authors.forename: Caglar
authors.initials: C
authors.lastname: Calli
mesh_terms: D000328:Adult; D003080:Cold Temperature; D004438:Ecchymosis / Q000209:etiology / Q000517:prevention & control; D004487:Edema / Q000209:etiology / Q000517:prevention & control; D058447:Eye Pain / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000009:adverse effects*; D020034:Silicone Gels
chemical_list: D020034:Silicone Gels