No more dressing after cochlear implantation: exposing benefits and simplifying care

Mastoid pressure dressings have traditionally been believed to reduce the risk of hematoma and seroma. However, recent studies suggest that these dressings may be unnecessary after uncomplicated middle ear and mastoid surgeries, as they do not appear to improve patient outcomes. Therefore, this study aimed to evaluate the role of mastoid pressure dressings in preventing postoperative complications following cochlear implant surgery.

This retrospective cohort study included 127 cochlear implant recipients, divided into two groups: 64 patients who underwent cochlear implant surgery with head dressing and 63 patients who underwent the cochlear implant surgery without head dressing. Medical records were reviewed, and relevant clinical data were collected and analyzed to compare postoperative outcomes between the two groups.

The mean age of the patients was 14.9 ± 14.4 years, and 59.8% male. Statistically significant differences were observed between the groups in the incidence of infection (P = 0.03) and focal skin necrosis (P = 0.03), both of which were higher among patients with head dressings. However, no statistically significant differences were found between the groups regarding overall postoperative complications, hematoma, edema, wound dehiscence, or keloid scar.

This study found no evidence supporting the routine use of mastoid pressure dressings to prevent complications following cochlear implant surgery. Conversely, their use was associated with a higher incidence of infection and focal skin necrosis. Given these findings, its application could be individualized according to specific clinical circumstances rather than routinely applied. Further prospective and controlled studies are needed for better validation.