Mizrachi Matti, Layous Eli, Dror Amiel A, Yakir Orly, Bader Ahmad, Sela Eyal
From the Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.
Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Plast Reconstr Surg Glob Open. 2023 Jul 12;11(7):e5112. doi: 10.1097/GOX.0000000000005112. eCollection 2023 Jul.
Postrhinoplasty periorbital ecchymosis is an inevitable side effect contributing to patients' psychological aspect and early postoperative morbidity. Efforts are constantly being made to reduce ecchymosis using different methods with varying success. To evaluate treatment response, it is mandatory to have a reliable score. Several studies suggest other scoring systems, but none has been postrhinoplasty-specific, validated, and accepted. This study aimed to demonstrate the natural history of postrhinoplasty ecchymosis, find potential risk factors for worsening patterns, and suggest a useful and reliable periorbital ecchymosis scoring system for postrhinoplasty follow-up.
This prospective study included 183 patients who underwent closed rhinoplasty by the same surgeon and the same principle method. Photographs of the periorbital ecchymosis were taken on postoperative days 1, 2, and 7. The periorbital area was divided into quarters, and three independent physicians assigned the dominant color of each quarter.
There were no significant variations between the three physicians' scoring. The interobserver consistency defined as an excellent scoring system reliability, according to our statistical analysis. The postoperative ecchymosis demonstrated a consistent pattern of spread over time, dominating the medial quarters on early postoperative days 1 and 2, following into the lower lateral quarters in postoperative day 7. We found no correlation between patient demographics and clinical characteristics to ecchymosis patterns and temporal spread.
Our study suggests a reliable and easy-to-use postrhinoplasty ecchymosis scoring system. This scoring method can be used for postrhinoplasty ecchymosis assessment and as a research-validated tool to quantify different perioperative treatments to reduce ecchymosis and estimate mid-face trauma.
鼻整形术后眶周瘀斑是一种不可避免的副作用，会影响患者的心理状态并导致术后早期发病。人们一直在努力采用不同方法减少瘀斑，但效果各异。为了评估治疗反应，必须有一个可靠的评分系统。多项研究提出了其他评分系统，但尚无针对鼻整形术后的、经过验证且被广泛接受的评分系统。本研究旨在阐明鼻整形术后瘀斑的自然病程，找出瘀斑加重模式的潜在危险因素，并提出一种用于鼻整形术后随访的实用且可靠的眶周瘀斑评分系统。
这项前瞻性研究纳入了183例由同一位外科医生采用相同原则方法进行闭合式鼻整形的患者。在术后第1天、第2天和第7天拍摄眶周瘀斑的照片。将眶周区域分为四个象限，由三名独立的医生确定每个象限的主色调。
三位医生的评分之间无显著差异。根据我们的统计分析，观察者间的一致性表明该评分系统具有出色的可靠性。术后瘀斑随时间呈现出一致的扩散模式，术后第1天和第2天主要集中在内侧象限，术后第7天扩散至下外侧象限。我们发现患者的人口统计学特征和临床特征与瘀斑模式及时间扩散之间无相关性。
我们的研究提出了一种可靠且易于使用的鼻整形术后瘀斑评分系统。这种评分方法可用于鼻整形术后瘀斑的评估，作为一种经过研究验证的工具，用于量化不同的围手术期治疗以减少瘀斑，并估计面中部创伤。
