[Comparison between dexamethasone and tranexamic acid on postoperative edema and ecchymosis after rhinoplasty operation]

Rhinoplasty is one of the most popular plastic surgery in the world. Edema and ecchymosis are two expected consequences after any planned injuries such as surgery that extend time and cause to distress for the patients and their families. Several drugs [e.g. corticosteroid and eranexamic acid] and herbal extracts [e.g. arnica] are suggested for resolving this problem but there is no comparison between them yet. This study was undertaken to compare the potential benefits of dexamethasone with tranexamic acid on postoperative edema and ecchymosis after rhinoplasty. Determination of dexamethasone and tranexamic acid efficacy on edema and ecchymosis after rhinoplasty. This was a clinical trial cross sectional double blind study. Seventy rhinoplasty candidates were randomized in two groups. In addition to routine management and cold compress after operation, one group received dexamethasone and another group received tranexamic acid injection for both groups 1 dose of drug before and 3 doses per 8 hours after rhinoplasty. For measurement of edema and ecchymosis, we took digital photos from patients' face third day of postoperation. Then three colleagues who were blinded to assigned groups, scored edema and ecchymosis level with using 0-4 point standard scale. The alpha<0.05 is considered significant statistically. Nineteen men and fifty one women were enrolled. On postoperative day 3, there was no significant difference in the rating of preorbital ecchymosis among two intervention groups [p<0.15]. Also there was no significant difference for the edema rating among two intervention groups [p<0.12]. According to our results, no significant difference in postoperative edema and ecchymosis was detected among two groups. In regard to similar efficacy of both drugs to decrease edema and ecchymosis after rhinoplasty, we must select one of them according to the other effects of drugs

[Evaluation of satisfaction rate of patients and physician from closed reduction of nasal fracture]

Nasal bone fracture is the most common facial fracture and the third most common fracture of the human skeleton. The diagnosis and proper treatment of the nasal bone fracture are based on physician's findings and skill. The way to manage the nasal bone fracture ranges from closed reduction to open reduction. Insufficient reduction caused secondary deformity after the swelling subside, and lead to requests of other surgical procedures. To evaluate satisfaction rate of patients and physician from outcome of closed reduction 1 month later nasal fracture. The descriptive study reviewed patients with nasal fracture and treated by closed reduction at Amir-al-momenin hospital [Rasht] in 2007-2008 years. According to physical examination and radiologic findings, nasal fractures were classified. Demographic data, time of injury, mechanisms and severity of fracture were recorded on data sheet. Patients were followed up 1 month later of nasal fracture and their satisfaction upon Likert scale was recorded. The physician described satisfaction as good, fair, poor. In this study from 67 patients 76.1% were male and 23.9% were female. Mean age of patients was 30.17 +/- 13.45 years. The major cause of the nasal fractures was attributed to fighting [43.3%]. B-type, U-type and F-type fractures composed 70.1%, 25.4% and 4.5% respectively. 26.9% of patients had soft tissues damages and 3% had fracture in other facial bone. 36 patients [53.7%] were satisfied, 17 patients [25.4%] were very satisfied and 14 patients [20.9%] were unsatisfied. None of them were very unsatisfied. Physician evaluated outcome as good, fair, and poor in 65.7% [44 cases], 23.9% [16 cases] and 10.4% [7 cases] respectively. Although, there isn't statistically significant difference between different type of fracture or presence of soft tissue damage and patients' satisfaction rate, there is statistically significant difference between them and physician's satisfaction rate [P=0.02 and P=0.049]. The results showed that in cases with severe fracture [F-type] and presence of soft tissue damage, closed reduction should be considered carefully as the choice of treatment