Mastoid pressure dressing for cochlear implantation-Is it necessary?

Objectives: Mastoid pressure dressing (MPD) with circumferential head bandage after middle ear surgery and cochlear implantation (CI) is used to minimize the postoperative hematoma and thus provides a good wound covering. But such dressing is usually uncomfortable for patients and may lead to other unpredictable complications. This study was aimed to evaluate the need for MPD following CI. Methods: Retrospective chart analysis of 92 consecutive patients who underwent CI. Results: The 92 patients had a median age of 4.3 years. All patients were categorized into those receiving either MPD or simple gauze dressing (SGD). Six MPD patients and five SGD patients had minor surgical-site complications (9.1% and 6.3%, respectively), a statistically insignificant difference. The key to preventing hematomas is careful tissue handling and minimally invasive techniques. MPD alone rarely provides enough pressure to prevent hematoma. Conclusions: This study found no clinically significant benefits for use of MPD following CI. We suggest abandoning the use of compression bandages after uncomplicated CI.