Knot to be condemned

It is common practice following mastoid and middle ear surgery to apply a pressure bandage to the ear for a short post-operative period to reduce local swelling. The bandage is usually secured in such a way as to lift it away from the eye, sometimes with a length of ribbon gauze tied in a knot over the temporal region. Pressure from the knot may cause injury to the underlying tissues leading to post-operative complications which hitherto have not been described.