Abstract
In this study, the psychological effects of single-dose corticosteroids administered to patients who had undergone rhinoplasty were assessed. A total of 30 rhinoplasty patients were included in the study and were randomly assigned to 1 of 2 groups. Preoperatively, patients completed the Bech Rafaelsen Mania Scale and the Beck Depression Inventory. Dexamethasone 10 mg was given intravenously just before surgery to the first group, but no medication was administered to the second group. On the first postoperative day, patients were seen again, and the Bech Rafaelsen Mania Scale and the Beck Depression Inventory were again completed. Periorbital edema and ecchymosis were graded, and psychological well-being was measured on a standard visual analog scale. All patients and physicians were blinded to treatment until the end of the study. Results show that administration of a single-dose of dexamethasone 10 mg caused neither euphoria nor depression. No significant differences were observed between steroid and control groups in terms of patients’ psychological well-being. With single-dose dexamethasone, periorbital edema was significantly reduced on the first 2 postoperative days, and upper eyelid ecchymosis was significantly decreased only on the first postoperative day. However, preoperative steroid administration had no influence on ecchymosis of the lower eyelid. The authors conclude that single-dose dexamethasone 10 mg can be used safely to reduce periorbital edema and ecchymosis in rhinoplasty patients.
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Kara CO, Gokalan I. Effects of single dose steroid usage on edema, ecchymosis and intraoperative bleeding in rhinoplasty.Plast Reconstr Surg. 1999; 104: 2213–2218.
Griffies WS, Kennedy K, Gasser C, Fankhauser C, Taylor R. Steroids in rhinoplasty.Laryngoscope. 1989; 99: 1161–1164.
Habal MB. Prevention of postoperative facial edema with steroids after facial surgery.Aesth Plast Surg. 1985; 9: 69–71.
Hoffmann DF, Cook TA, Quatela VC, Wang TD, Brownrigg PJ, Brummett RE. Steroids and rhinoplasty: a double-blind study.Arch Otolaryngol Head Neck Surg. 1991; 117: 990–993.
Kara CO, Kara IG, Topuz B. Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty?J Oral Maxillofac Surg. 2005; 63: 1088–1090.
Kara CO, Kara IG, Yaylali V. Subconjunctival ecchymosis due to rhinoplasty.Rhinology. 2001; 39: 166–168.
Kargi E, Hosnuter M, Babuccu O, Altunkaya H, Altinyazar C. Effect of steroids on edema, ecchymosis, and intraoperative bleeding in rhinoplasty.Ann Plastic Surg. 2003; 51: 570–574.
Kaschke O. Postoperative care and management. In: Behrbohm H, Tardy ME Jr, eds.Essentials of Septorhinoplasty. Stuttgart: Georg Thieme Verlag; 2004: 234–236.
McCharthy JG, Wood-Smith D. Rhinoplasty. In: McCharthy JG, ed.Plastic Surgery. Philadelphia, Pa: WB Saunders; 1990: 1785–1894.
Tebbet JB.Primary Rhinoplasty. St Louis, Mo: Mosby; 2000.
Echavez MI, Mangat DS. Effects of steroids on mood, edema, and ecchymosis in facial plastic surgery.Arch Otolaryngol. 1994; 120: 1137–1141.
First MB, Spitzer RL, Gibbon M, Williams JBW.Structured Clinical Interview for DSM-IV Clinical Version (SCID-I/CV). Washington, DC: American Psychiatric Press; 1997.
Bech P, Bolwing TG, Kramp P, Rafaelson OJ. The Bech-Rafaelson Mania Scale and the Hamilton Depression Scale: evaluation of homogeneity and inter-observer reliability.Acta Psychiatr Scand. 1979; 59: 420–430.
Beck AT. An inventory for measuring depression.Arch Gen Psychiatry. 1961; 4: 561–571.
Owsley JQ, Weibel TJ, Adams WA. Does steroid medication reduce facial edema following face lift surgery? A prospective, randomized study of 30 consecutive patients.Plast Reconstr Surg. 1996; 98: 1–6.
Schimer BP, Parker KL. Adrenocorticotropic hormone, adrenocortical steroids and their synthetic analogs, inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman JG, Limbird EL, Molinoff PB, Gilman AG, eds.Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill; 1996: 1442–1454.
Cawson RA, James J. Adrenal crisis in a dental patient having systemic corticosteroids.Br J Oral Surg. 1973; 10: 305–309.
Brown ES, Khan DA, Nejtek VA. The psychiatric side effects of corticosteroids.Ann Allergy Asthma Immunol. 1999; 83: 495–503.
Brown ES, Suppes T. Mood symptoms during corticosteroid therapy: a review.Harv Rev Psychiatry. 1998; 5: 239–246.
Patten SB, Williams JV, Love EJ. A case-control study of corticosteroid exposure as a risk factor for clinically diagnosed depressive disorders in a hospitalized population.Can J Psychiatry. 1995; 40: 396–400.
Lewis DA, Smith RE. Steroid-induced psychiatric syndromes: a report of 14 cases and a review of the literature.J Affect Disord. 1983; 5: 319–332.
Klein JF. Adverse psychiatric effects of systemic glucocorticoid therapy.Am Fam Physician. 1992; 46: 1469–1474.
Assimes TL, Lessard ML. The use of perioperative corticosteroids in craniomaxillofacial surgery.Plast Reconstr Surg. 1999; 103: 313–321.
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Ozdel, O., Kara, C.O., Kara, I.G. et al. Does corticosteroid usage in rhinoplasty cause mood changes?. Adv Therapy 23, 809–816 (2006). https://doi.org/10.1007/BF02850322
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DOI: https://doi.org/10.1007/BF02850322