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Are head bandages really required after middle-ear surgery? A systematic review

  • I Khan (a1), S Mohamad (a1), S Ansari (a1) and A Iyer (a1)

Abstract

Objective:

A systematic review was performed to evaluate the role and effectiveness of head bandages after routine elective middle-ear surgery.

Methods:

Studies that compared the effectiveness of head bandage use after elective middle-ear surgery (e.g. myringoplasty, mastoidectomy and cochlear implantation) were identified using the following databases: Ovid Medline and Embase, the Ebsco collections, the Cochrane Library, PubMed, and Google Scholar. An initial search identified 71 articles. All titles and abstracts were reviewed. Thirteen relevant articles were inspected in more detail; of these, only five met the inclusion criteria. These included three randomised, controlled trials, one retrospective case series and one literature review.

Results:

The three randomised, controlled trials (level of evidence 1b) showed no statistically significant differences in post-operative outcomes (in terms of complications) associated with head bandage use in middle-ear surgery. This finding was supported by the retrospective case series involving patients undergoing cochlear implantation.

Conclusion:

Current available evidence shows no advantage of head bandage use after middle-ear surgery. Head bandages may not be required after routine, uncomplicated middle-ear surgery.

Copyright

Corresponding author

Address for correspondence: Mr Imran Khan, Ward 9, Monklands Hospital, Airdrie ML5 0JS, Scotland, UK E-mail: drkhanimran@gmail.com

Footnotes

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Presented at the 8th SAARC ENT Congress, 19–21 December 2013, Karachi, Pakistan, and at the 10th Annual National ENT Masterclass, 24–26 January 2014, London, UK.

Footnotes

References

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1Gurgel, RK, Oghalai, JS. Are mastoid pressure dressings necessary after otologic surgery to prevent postoperative hematomas? Laryngoscope 2012;122:485–6
2Castelli, ML, Lisi, D, Marcato, P, Tavormina, P, Capellaro, E, Sartoris, A. Is pressure dressing necessary after ear surgery? Ann Otol Rhinol Laryngol 2001;110:254–6
3Demir, Y, Haktanir, N, Yilmaz, MD. Dangers of tight head dressing. Aesthetic Plast Surg 2004;28:256
4Rowe-Jones, JM, Leighton, SE. The value of head dressings for middle ear surgery. J Laryngol Otol 1993;107:1719
5Critical Appraisal Skills Programme (CASP) checklists. In: http://www.casp-uk.net/#!checklists/cb36 [1 June 2015]
6Oxford Centre for Evidence-based Medicine – Levels of Evidence (March 2009). In: http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/ [1 June 2015]
7Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535
8Ergin, NT, Dal, T, Ozluoglu, KN. Is mastoid dressing necessary for routine postoperative management of middle ear and mastoid surgery? [In German] Otorhinolaryngol Nova 1998;8:304–7
9Luo, SD, Chih-Ying, S, Hwang, CF. Mastoid pressure dressing for cochlear implantation – is it necessary? Int J Pediatr Otorhinolaryngol 2009;73:857–60
10Hill, J, Allan, W, Malhan, D, Williams, ED. Pressure exerted by head bandages used in otological surgery. J Laryngol Otol 1993;107:1110–11

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