The aim of this study was to investigate the efficacy of
tranexamic acid (TA) and
methylprednisolone on periorbital
edema,
ecchymosis, and intraoperative
bleeding in patients who underwent open septorhinoplasty (oSRP). Seventy-five patients performing hump extraction and
osteotomies were allocated into 3 groups as follows: group 1, 25 patients as control; group 2, 25 patients who were administered oral TA as first dose 1 g starting 2 hours before surgery, 3 g daily in divided doses (1 g, every 8 hours) for 5 days; and group 3, 25 patients who were administered a single dose of 1 mg/kg intravenous
methylprednisolone at the beginning of the surgery. Operation time, amount of intraoperative
bleeding, and complications were recorded. Scoring of eyelid
edema and periorbital
ecchymosis was evaluated on postoperative first, third, and seventh days using scale of 0 to 4 by 2 observers. In groups using TA and
methylprednisolone, periorbital
edema and
ecchymosis scores were significantly lower compared with the control group (P < 0.05). No significant difference was seen clinically and statistically in preventing or decreasing both periorbital
edema and
ecchymosis between group 2 and group 3. Patients given TA showed significantly less intraoperative
bleeding compared with controls and patients who were administered
methylprednisolone. We observed that the administration of
methylprednisolone significantly decreases periorbital
edema and
ecchymosis. Additionally, our results support that TA use in patients who underwent oSRP with
osteotomies was found clinically and statistically effective for prevention of
bleeding during oSRP operations and reduction of both periorbital
edema and
ecchymosis.