Is mastoid head bandage really required in patients undergoing middle ear surgery? a randomised control trial

Abstract

Background: Middle ear surgery is a common procedure addressing various pathologies. Postoperative head bandaging has traditionally been used to provide support and prevent complications. However, its necessity remains controversial, with limited empirical evidence supporting its routine use. Objective: This randomised controlled trial (RCT) evaluated the necessity of head bandaging in middle ear surgery by comparing postoperative complications between a mastoid head bandage and a simple gauze dressing. Methods: Eighty patients scheduled for middle ear surgery were randomly assigned to two groups: the Pressure Bandage group, where a crepe bandage was wrapped around the head, and the No Pressure Bandage group, where a gauze dressing was secured with Mefix tape. All surgeries were performed by a single otolaryngologist using standardised techniques, with the surgeon blinded to the dressing type. Postoperative complications, including hematoma, erythema, skin abrasion and wound infection, were recorded and compared. Results: The mastoid bandage group had a significantly higher incidence of forehead skin abrasions (6/40 vs. 0/40, p = 0.026). No significant differences were observed in hematoma or seroma formation, as neither group developed these complications. Conclusion: Routine mastoid head bandaging does not appear necessary, as it does not reduce postoperative complications and may increase patient discomfort due to skin abrasions. Larger studies with longer follow-ups are recommended to strengthen these findings and guide clinical practice.