External Splinting Is Not Mandatory After All Rhinoplasties: A Prospective Randomized Trial.

Background: Although casts or external splint materials are commonly applied on the external nose after rhinoplasty, their beneficial effects have not been previously demonstrated in controlled studies.

Methods: A total of 40 adult patients who underwent primary rhinoplasty were included in this prospective study. The patients were randomized into 2 groups to use an external splint or not after surgery. Only surgical taping was applied to the nasal dorsum of the patients for whom external splints were not used. The periorbital edema and ecchymosis levels of the patients were recorded on the second and seventh days after surgery. Moreover, all patients had a computed tomography scan at the third postoperative week to measure the distance between the beginning of the osteotomy line on the right and left sides and the midline.

Results: On the second and seventh postoperative days, the levels of periorbital edema and ecchymosis were significantly lower in the patients with taping than in the patients with splints (P < 0.05 for each). No statistically significant difference was observed in terms of the difference in the distance between the beginning of the osteotomy line on the right and left sides to the midline between the group with external splints and that with tape (P = 0.661).

Conclusions: External splinting may not be used in cases where osteotomy is not performed or in patients where the osteotomies are sufficiently stable. Thus, the disadvantages of external splinting are avoided, and at the same time, periorbital edema and ecchymosis are less common.