Comparing the efficacy of different steroids for rhinoplasty: A systematic review and network meta-analysis of randomized controlled trials

Background: Rhinoplasty can cause tissue trauma , inflammatory responses. Edema and ecchymosis, especially on the face, accompanied by inflammation are common complications. The anti-inflammatory properties of steroids can reduce postoperative edema , ecchymosis.Objective: This review aims to determine the most effective type of steroids for preventing complications related to rhinoplasty.Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The population of comprised patients who underwent rhinoplasty or septorhinoplasty. Different types of steroids administrated in- travenously during the perioperative period were compared. The primary outcome of post- operative edema and other outcomes were evaluated on postoperative day 1, 3 , 7. Random-effects model was performed. The means and standard deviations were extracted.Results: Eighteen randomized controlled trials were included. The network meta-analysis re- vealed that dexamethasone and methylprednisolone significantly reduced edema on post- operative day 1 compared with placebo. No significant differences between the effects of any of two types of steroids were noted.Conclusion: At least one dose of intravenous steroid intervention is recommended during the perioperative period of rhinoplasty. However, in terms of reducing edema and ecchymosis, no significant differences were noted among dexamethasone, methylprednisolone, and beta- methasone.& COPY; 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.