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BACKGROUND: 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 = 0.894). There was a statistically significant lower mean intraoperative bleeding level in Group 2 from the other groups (p = 0.020). 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 < 0.05), and significantly lower scores for postoperative ecchymosis at the end of the operation (p = 0.013) and on the 3rd day (p = 0.024). Although group 3 had a lower score than the other groups in the ecchymosis measurements on the 1st, and 7th days, no statistically significant results were obtained. 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. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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PURPOSE: Our aim is identify a new approach to vocal cord leukoplakia treatment and detect to efficiency of proton pump inhibitors. STUDY DESIGN: Prospective, nonrandomized experimental clinical trial. METHODS: A 'First Assessment Scale' was prepared. This scale included the lesion's and the patient's characteristics. Using this scale, 24 patients included to the study. 20 mg rabeprazole twice daily was applied to all patients. At the end of 3rd month, a 'Second Assessment Scale' was used and two groups created. In group 1, 19 patients were accepted to responsive for the therapy and received the same therapy. The group 2 was included five patients that accepted unresponsive to treatment and directed to surgery. All patients received the same treatment additionally 3 months. At the end of 6th month, the Reflux Symptom Index (RSI), the Reflux Finding Score (RFS) and the Red-Green-Blue (RGB) values evaluated and comparisons were made. RESULTS: The RSI and RFS values were significantly decreased in all patients. The Red values were significantly decreased with treatment in group 1, but the Green and Blue values were not. In group 2, the RGB values were not showed the significant differences. In conclusion, seven patients (29,2%) showed complete lesion regression, 12 patients (50%) showed partial lesion regression and five patients (20,8%) showed no response to treatment. CONCLUSIONS: The proton pump inhibitor treatment may be beneficial for the selected patients. The scales that we prepared were useful for lesion assesment.