The causes of PERIORBITAL ECCHYMOSIS are traumatic and non-traumatic head and neck insults. This report deals with a non-traumatic bilateral spontaneous PERIORBITAL ECCHYMOSIS in pregnancy.The case studied was a 24-year-old woman in her eighth month of pregnancy who realized her spontaneous ECCHYMOSIS around both eyes which was more prominent in the right eye 12 hours after vomiting. She did not have any history of head and neck trauma or surgery. Her visual acuity, ophthalmic examination, blood pressure, and urine analysis were normal. Twenty days after the first evaluation, the ECCHYMOSIS completely recovered and the patient was well completely after six months. Although, there are systemic and local causes in the etiology of PERIORBITAL ECCHYMOSIS, spontaneous occurrence of the condition in a pregnant woman not having preeclampsia is unknown.

Introduction: A double blind, randomized study was designed to determine the efficacy of dexamethasone in decreasing PERIORBITAL edema and ECCHYMOSIS after rhinoplasty Materials and Method: Sixty rhinoplasty patients undergoing open rhinoplasty surgery with tip modification, hump resection and bilateral osteotomy were included in the study and were enrolled in 3 groups: group 1: 20: a single dose of 8 mg dexamethasone at the beginning of operation. Group 2: 20: three doses of 8 mg dexamethasonefirst at the beginning of operation and then 24 and 48 h postoperatively. Group 3: 20 control group with no medication used.Results: Significant reduction in PERIORBITAL edema and ECCHYMOSIS was obvious in groups land 2 compared with control group 3. PERIORBITAL edema and ECCHYMOSIS during the end of first postoperative week was lower in group 2 compared with group 1.Conclusion: steroid administration before osteotomy reduced edema and ECCHYMOSIS significantly. Patients can return to their normal lives earlier with this reduction in postoperative edema and ECCHYMOSIS.

Introduction: In this study we try to determine the effects of sub periosteal tunneling before intranasal lateral osteotomies during rhinoplastic operation on PERIORBITAL edema and ECCHYMOSIS.Materials and Methods: In 50 patients we carried out 100 lateral osteotomies which 50 without subperiosteal tunneling and 50 after subperosteal tunneling in a fashion that in each patient in one side we did sub perosteal tunneling and in the other side not.Then an other surgeon compared PERIORBITAL edema, ECCHYMOSIS and subcojunctival ECCHYMOSIS in each patient separately on 3rd postoperative day.Results: There was significant increment in perorbital edema, ECCHYMOSIS and subcojunctival ECCHYMOSIS in the side of patient whom subperiosteal tunneling carried out before itranasal lateral osteotomy.Conclusion: we sugest performing lateral osteotomies without subperiosteal tunneling during a rhinoplastic operation.

Background: In rhinoplasty, PERIORBITAL edema and ECCHYMOSIS is due to soft tissue trauma and small vessel injury with subsequent exudation and bleeding. The main purpose of this study is to determine the effect of dexamethasone in reducing PERIORBITAL edema and ECCHYMOSIS and intraoperative bleeding in rhinoplasty patients.Methods: This double-blind study included 90 patients who underwent rhinoplasty from October 2004 to March 2005. In group A, 8 mg of intravenous dexamethasone was administered only preoperatively. In group B, 8 mg of dexamethasone was administered preoperatively and continued every 8 hours postoperatively. Group C, the control group, received no dexamethasone.Results: The degree of upper lid edema in groups A and B was significantly less than that of group C. During the first and second day the severity of upper lid edema in group B was less than that of group A, but the difference was not significant. The degree of lower lid edema during the first and second days in groups A and B was significantly less than that of group C, although it was identical in all groups during the fifth and seventh days. The degree of upper lid ECCHYMOSIS during the first and fifth days in group C was significantly more than that of groups A and B, but it was similar on the seventh day in all groups. The degree of lower lid ECCHYMOSIS on the first day in groups A and B was significantly less than that of group C; however, it was similar in all groups during the second, fifth and seventh days. The volume of intraoperative bleeding in the three groups was similar. The mean period of recovery (12 days) was comparable in all groups.Conclusions: Dexamethasone administration leads to the reduction of upper lid edema, ECCHYMOSIS and lower lid edema during the first and second postoperative days, and reduction of lower lid ECCHYMOSIS on the first postoperative day.

Introduction: Nasal fracture is one of the most common cases referred to the ENT clinics. This study aimed to determine the value of conventional radiography in the diagnosis of patients with nasal injuries.Methods: In this study, all patients with nasal injury referred to the Emergency Department of Imam Khomeini, Ahvaz, Iran, were reviewed. After Radiography was done, cases were investigated.Results: Of the 174 patients that had clinical diagnos is of nasal fracture, just 74% (141 cases) had positive findings in Radiology. For fractures and 19% (33 patients) had no findings for nasal fracture in X-ray.26% (48 patients) had significant ECCHYMOSIS and 72% (126 cases) had no PERIORBITAL ECCHYMOSIS.Conclusion: Radiolography in nasal fracture is benefit less than clinical examination. But, it is recommended to confirm the diagnosis of clinically suspected cases and for legal issues.

Background: Postoperative PERIORBITAL edema and ECCHYMOSIS are common after rhinoplasty. We studied the effect of local injection of Lidocaine/Adrenaline immediately before osteotomy on prevention of post-operative PERIORBITAL edema and ECCHYMOSIS in rhinoplasty.Materials and Methods: Thirty healthy candidates for rhinoplasty were enrolled in the self-controlled clinical trial study. Lidocaine/Adrenaline solution injected randomly to one side just prior to the lateral osteotomy. The opposite side used as a control. The degree of edema/ECCHYMOSIS on both sides was compared on the 1st, 2nd and 7th day postoperatively.Results: Mean of severity of edema, 24 hours after operation was 3in both sides, (Mann-whitney U; p=0.829). Mean of severity of edema, 48 hours after operation was 2 in both sides (Mann-whitney U; p=0.867) and it was 1 in both sides 7 days after operation (Mann-whitney U; p=0.756).There was no significant difference between two sides. Mean of severity of ECCHYMOSIS, 24 hours after operation was 3 in both sides (Mann-whitney U; p=0.692). Mean of severity of ECCHYMOSIS, 48 hours after operation was 2 in both sides (Mann-whitney U; p=0.655) and it was 1 in both sides 7 days after operation (Mann-whitney U; p=0.873). There was no significant difference between two sides.Conclusion: local injection of Lidocaine/Adrenaline solution immediately before lateral osteotomy could not reduce postoperative edema and ECCHYMOSIS in rhinoplasty.

Introduction: Postoperative PERIORBITAL edema and ECCHYMOSIS is one of the main complication of rhinoplasty. This complication is mostly due to lateral osteotomy. During performing the endonasal lateral osteotomy, with the goal of reducing injury to surrounding tissues and reducing the postoperative edema and ECCHYMOSIS. The aim of this study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative PERIORBITAL edema and ECCHYMOSIS.Methods: 102 patients were included in the study. They were underwent rhinoplasty. In each patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel with periosteum elevator on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The rest of the procedure was similar bilaterally. The patients were examined on the 2nd and 7th days after surgery. The levels of edema and PERIORBITAL ECCHYMOSIS were score by a different surgery who was unaware of the side with the periosteal tunnel, and the results were compared together.Results: According to the data analysis, there was no statistically significant difference between the severity of PERIORBITAL edema at the side with subperiosteal tunnel and the side without it on the 2nd and 7th days after surgery (P value=0.096 and Pvalue=0.252, respectively). There was not found any statistical significant between PERIORBITAL ECCHYMOSIS at the side with subperiosteal tunnel and the side without it on the 2nd and 7th days after surgery (P value=0.783 and Pvalue=0.094, respectively).Conclusions: Creating a subperiostal tunnel before lateral osteotomy in rhinoplasty does not influence on the severity of postoperative edema and ECCHYMOSIS.

Background & Objectives: The lateral nasal osteotomy is an integral part of cosmetic surgery (rhinoplasty). A reproducible and predictable technique with the least complication is a significant contributor to operation success. Regarding the different techniques and instrumentation for osteotomy, this study was carried out with the aim of comparison of ECCHYMOSIS severity due to lateral osteotomy in internal continuous and external perforated techniques in Tehran from 2004 to 2005. Materials & Methods: This clinical trial was conducted on 30 patients ( 15 males and 15 females ). The entire patients had the same situation pre and post operation. In each patient both internal and external osteotomy were performed , and ECCHYMOSIS severity due to operation was measured using a ruler on the 1st, 2nd, 3rd, 5th and 7th day following the operation. The data were analysed through SPSS (Smirnov & kolmograph, repeated measure and Wilks tests). Results: The study results indicated that the ECCHYMOSIS severity was far lower in external method than internal method (P=0.01) and it was higher in lower eyelids than in upper eyelids  (P=0.01). ECCHYMOSIS severity was higher on the 3rd day than the other days and it gradually declined from 3rd to 7th days. Age had no significant association with ECCHYMOSIS severity while its rate was higher in men than in women (P=0.01). Conclusions: External osteotomy causes less ECCHYMOSIS severity compared to internal technique and has other advantages confirmed by other researchers. Thus, it can be introduced as a preferable educational technique.