The Effect of Drainage Cannula Use on Postoperative Periorbital Edema and Ecchymosis After Primary Rhinoplasty

Background: Periorbital edema and ecchymosis are common early postoperative findings after rhinoplasty. Objective: The aim of this study was to evaluate and compare postoperative periorbital edema and ecchymosis between patients who underwent primary rhinoplasty with a transnasal drainage cannula placed through the osteotomy site and those without, using photographic analysis and patient-reported outcomes. Methods: Seventy-two patients undergoing primary rhinoplasty were randomized to drainage group (16G intravenous cannula inserted through the osteotomy site for 24 h [ n = 36]) or no drainage [ n = 36]. Blinded raters graded edema and ecchymosis on days 1, 7, and 28. Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) was completed preoperatively and on day 28. Results: The mean age was 29.2 ± 9.0 years in the cannula group and 26.3 ± 9.7 years in controls; 66.7% and 58.3% were female, respectively, and all patients completed 28-day follow-up. The cannula group demonstrated less edema and ecchymosis on days 1 and 7 compared with controls ( p < 0.05). No significant differences were observed on day 28. Day-28 SCHNOS total scores were similar between groups (cannula: 11.00 [95% confidence interval (CI), 8.40–13.60] vs control: 13.86 [95% CI, 10.33–17.39]). Conclusion: Temporary transnasal cannula drainage after primary rhinoplasty with osteotomies was associated with less early periorbital edema and ecchymosis with no difference by postoperative day 28.