Local Delivery of Tranexamic Acid and Dexamethasone via Piezoelectric Irrigationin Rhinoplasty: A Prospective Double-Blind Comparative Study of Early Postoperative Morbidities

This study aimed to evaluate the effects of adding tranexamic acid (TXA) and dexamethasone to the irrigation solution of a piezoelectric device during open rhinoplasty on postoperative periorbital edema, ecchymosis, and pain. In this prospective, non-randomized, double-blind, comparative study, 81 patients undergoing primary open rhinoplasty with a piezoelectric device were enrolled. Patients were categorized into three groups according to the irrigation solution used: Group 1 received saline with 500 mg TXA, Group 2 received saline with 16 mg dexamethasone, and Group 3 received plain saline irrigation (control group). No significant differences were observed among the groups in periorbital edema on postoperative day 1. On day 3, edema scores were significantly higher in the control group than in both the TXA and dexamethasone groups, with no difference between the TXA and dexamethasone groups. No significant differences were observed on days 7 and 14. Regarding ecchymosis, no significant differences were observed on days 1 and 3, nor between the dexamethasone and control groups on days 7 and 14. However, ecchymosis scores on days 7 and 14 were significantly higher in the control group than in the TXA group. Pain scores did not differ between the TXA and dexamethasone groups on day 1; however, the control group had significantly higher scores than both groups. On day 3, pain scores were higher in the control group than in both treatment groups, and higher in the TXA group than in the dexamethasone group. No significant differences were observed on days 7 and 14. The addition of dexamethasone or TXA to the irrigation solution may reduce early postoperative edema and pain. Dexamethasone showed a greater effect on early pain control, whereas TXA provided a more sustained reduction in postoperative ecchymosis.