Table 1.
TXA in Rhinoplasty
| Authors | Journal and Year | Study Design | Study Group (Total No.) | Surgery Type | Administration Mode and Dosage | Main Clinical Outcome | Main Results | Complications Related to TXA |
|---|---|---|---|---|---|---|---|---|
| Sakallioglu et al | Annals of Plastic Surgery 2015 | RCT | 25 (75)No significant difference among the 3 groups: control, TXA, Cs | Open septorhinoplasty | ORAL: 1 g starting 2 h before surgery, 3 g daily in divided doses (1 g, every 8 h) for 5 days | Operation timeIntraoperative bleedingPostoperative eyelid edema and periorbital ecchymosisCompare result with corticosteroids | Decrease in intraoperative bleeding compared with control and corticosteroid group (P < 0.05)Decrease in periorbital edema and ecchymosis scores compared with control group (P < 0.05)No significant difference in decreasing both periorbital edema and ecchymosis between TXA and corticosteroid | None |
| Mehdizadeh et al | Aesthetic Plastic Surgery Journal 2017 | RCT | 30 (60)No significant difference among the 4 groups: TXA, control, Cs, TXA + Cs | Primary open rhinoplasty | IV: 10 mg/kg IV 1 h before and 3 doses every 8 h after surgery | Postoperative eyelid edema and periorbital ecchymosis | Decrease in periorbital edema and ecchymosis scores compared with the control group (P < 0.01).No significant difference between TXA and Corticosteroid separately or together | None |
| Eftekharian et al | The Journal of Craniofacial Surgery 2016 | RCT | 25 (50)No significant difference between the 2 groups: control, TXA | Rhinoplasty (no specifications) | ORAL: 1 g (two 500-mg tablets) TXA orally 2 h before surgery | Intraoperative bleeding | Decrease in total blood loss (P = 0.005). Lower mean surgery duration (P = 0.017) | None |
| Beikaei et al | Biomedical & Pharmacology Journal 2015 | RCT | 48 (96)2 groups: control, TXA | Open rhinoplasty | IV: 10 mg/kg TXA during induction | Intraoperative bleeding | TXA was associated with a 15.6-mL decrease in intraoperative bleeding (P < 0.001) | None |
| Ghavimi et al | Journal of Cranio-Maxillofacial Surgery 2017 | RCT | 24 (50)No significant difference between the 2 groups: control, TXA | Closed rhinoplasty | IV: 10 mg/kg TXA before surgery | Intraoperative bleedingPostoperative eyelid edema and periorbital ecchymosis | Decrease in the mean of intraoperative bleeding (P = 0.013)Decrease in eyelid edema and periorbital ecchymosis (P = 0.03) | None |
| de Vasconcellos et al | JAMA Otolaryngology– Head & Neck Surgery 2018 | Meta-analysis | 5 RCT, including 276 patientsSignificant heterogeneity among studies (I2 = 84%) | Rhinoplasty | IV and ORAL | Intraoperative bleedingPostoperative eyelid edema and periorbital ecchymosis | TXA was associated with reduced bleeding by 42.28 mL compared with the placeboEyelid edema and ecchymosis scores in patients receiving tranexamic acid were significantly lower compared with the control group within the first postoperative weekOral tranexamic acid was associated with a greater reduction in intraoperative bleeding compared with intravenous tranexamic acid, 10 mg/kg | None |
| McGuire et al | JAMA Facial Plastic Surgery 2019 | Meta-analysis | 5 RCT, including 332 patientsLow degree of clinical heterogeneity | Rhinoplasty | IV and ORAL | Intraoperative bleedingPostoperative eyelid edema and periorbital ecchymosis | TXA treatment resulted in a mean reduction in intraoperative blood loss of −41.6 mL compared with controls (P = 0.004) | None |
Cs, Corticosteroid.