Nonshaved Ear Surgery: Effect of Hair on Surgical Site Infection of the Middle Ear/Mastoid Surgery and Patients' Preference for the Hair Removal

BACKGROUND AND OBJECTIVES: This study aimed 1) to compare the rates of surgical site infection (SSI) between two groups with and without preoperative hair shaving, 2) to compare the bacterial colonization just before the skin incision between them, and 3) to evaluate people’s preference for the hair shaving. SUBJECTS AND METHODS: The retrospective study enrolled cases in which middle ear and mastoid surgery was performed with as well as without hair removal. Main measurement outcomes were the SSI rate within 3 months following the surgery, bacterial culture results obtained from the incision area just before the skin incision, and questionnaire to evaluate the preference for hair shaving from patients with chronic suppurative otitis media but without experience with the ear surgery. RESULTS: This study did not show any difference in the rates of SSI and bacterial colonization between two groups with and without preoperative hair shaving. Most patients without experience with the ear surgery chose the nonshaved ear surgery, even though the questionnaire presented a comment as follow; “Your hair will always grow back as the growth speed of about 1.25 cm per month.” CONCLUSIONS: There is no evidence showing that preoperative shaving of the surgical site is helpful for the SSI than no hair removal. Nonshaved middle ear and mastoid surgery via postauricular approach appears to be preferable. Contrary to doctors’ popular belief, the hair shaving can cause psychological discomfort, especially for women. Now is the time to keep the balance between the professional’s perspective and the patients’ preferences.

Clinical Characteristics of Idiopathic Epidermoid and Dermoid Cysts of the Ear

BACKGROUND AND OBJECTIVES: Epidermoid and dermoid cysts are benign cystic lesions, lined by ectodermal squamous epithelium. They are not common in the head and neck areas, which constitute ~7% of all cases of epidermoid and dermoid cysts. The aim of this study was to investigate the clinical characteristics of epidermoid and dermoid cysts that developed around the ear. SUBJECTS AND METHODS: The clinical records were retrospectively reviewed for patients confirmed histologically as idiopathic epidermoid and dermoid cysts of the ear from January 2011 to December 2015. RESULTS: Total 15 cases consisted of 14 epidermoid cysts and only 1 dermoid cyst. There were 11 males and 4 females (mean age of 37.8±16.8 years old). Right side was 7 cases and left was 8. The cyst was located at the lobule in 4 cases, at the ear canal in 4 cases, at the preauricular area in 4 cases, and at the postauricular area in 3 cases. In cases of epidermoid cysts, there was no significant difference in age, sex, and size according to the location. Patients with cysts on helix were younger than others. CONCLUSIONS: This study demonstrated that most cutaneous cysts developing around the ear were epidermoid cysts and there was no site preference for occurrence of epidermoid cysts.