(1238) Tranexamic Acid and Rhinoplasty: How Do Different Administration Routes Affect Effectiveness?

Introduction: The aim of this study was to evaluate the effectiveness of the intravenous, oral and local application of tranexamic acid in operation time, intraoperative bleeding, postoperative edema and ecchymosis in rhinoplasty.

Methods: This was a randomized, double-blinded, prospective study. We included 146 patients who underwent rhinoplasty at the Bezmialem Vakif University Medical Faculty Otorhinolaryngology Clinic between April 2021 and April 2022. The patients were divided into four groups: Group 1 (intravenous TXA), Group 2 (oral TXA), Group 3 (topical TXA), and Group 4 (control). Operation time was recorded. Bleeding volume was measured in the suction chamber and nasopharyngeal pack. Postoperative edema and ecchymosis were evaluated using a scale at the end of the operation, on the 1st, 3rd, and 7th days.

Results: There was no statistically significant difference between groups in terms of mean operation time (p=0.581) and intraoperative bleeding (p=0.60). Group 3 had significantly lower scores for postoperative edema than the other groups at the end of the operation, on the 1st, 3rd, and 7th days (p < 0.001 for all), and significantly lower scores for postoperative ecchymosis at the end of the operation (p=0.010), on the 1st day (p=0.020), and on the 3rd day (p < 0.001), but not on the 7th day (p=0.059).

Conclusions: Local application of tranexamic acid is founded more beneficial for reducing postoperative edema and ecchymosis in rhinoplasty than intravenous and/or oral applications in this study.