Are subconjunctival hemorrhage and recovery times post-Rhinoplasty different for patients with different patterns in multivitamin intakes?

Aim: The study aimed to assess the correlation between potential confounders and factors like tranexamic acid use, multivitamin supplementation, dexamethasone administration, post rhinoplasty thermoplastic splinting, and patients' demographic and obesity statuses on the likelihood of achieving or maintaining a certain grade according to the SCH grading system. It also assessed recovery within one week after post rhinoplasty procedures.
Methods: A retrospective study was conducted on rhino plastic surgery patients at Prince Hashem bin Abdullah II Military Hospital in Aqaba and Lutron Military Hospital in Amman from January 2023 to December 2024. The study included patients aged 19-59, with a documented history of multivitamin supplementation. Data included characteristics, physical measurements, comorbidity, post-rhinoplasty splinting, complications, and procedure duration. Post-rhinoplasty subconjunctival hemorrhages were graded using Kara et al.'s approach. The study aimed to identify influential factors and assess the clinical importance of persistent postprocedural SCH within one week.
Results: A study involving 269 rhinoplasty patients found no significant differences in subconjunctival hemorrhage (SCH) episodes on the first day after surgery, second day, and complete healing within the first week. Two significant variables were delivering a 2 g tranexamic acid (TXA) injection before surgery and eating a multivitamin (MV) tablet before surgery. The probability of receiving MV supplementation was 0.316, while the risk of receiving a TXA therapy was 0.022. The Grade II SCH logistic regression model predicted between 51.4% and 72.1%. The study also examined how MV supplementation and dexamethasone injection influenced results pre- and post-surgery. The model's accuracy, specificity, and sensitivity scores changed from 34.0% to 47.7%, with an expected uncertainty of 34.0% to 47.7%.
Conclusion: The study suggests that individuals who have undergone rhino plastic procedures should consider taking multivitamins to reduce the risk of severe complications. Obesity can also negatively impact the risk of grade 2 subconjunctival hemorrhages on the first day after surgery. Dexamethasone before surgery can reduce bleeding and speed up recovery. Lowering the body mass index and using tranexamic acid during the perioperative period are also recommended.