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.

Transnasal Endoscopic Resection of a Pleomorphic Adenoma Originate From Nasal Floor.

A 81-year-old female presented to our hospital frequent epistaxis. Nasal endoscopy showed a mass obstructing nasal cavity completely and occupying middle meatus. Magnetic resonance imaging was performed, an about 4.8 × 4 × 4.2 cm sized heterogeneous T2 high signal intensity and T1 enhancing mass mainly involving right nasal cavity with invasion of right hard palate with bony destruction. Therefore, the authors planned to do endoscopic mass excision, under general anesthesia for diagnosis and treatment. The authors removed the mass from lateral nasal wall, nasal roof, nasal septum, medial maxillary wall by piece-meal. Margins of mass were clear except the nasal floor. So, the authors did frozen biopsy to confirm the clear margin in nasal floor. Endoscopy enables better visualization of tumor margins, facilitating complete removal and avoiding excessive resection and following up using good visualization.

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.

Evaluation of temporal bone pneumatization with growth using 3D reconstructed image of computed tomography.

OBJECTIVE: To evaluate temporal bone pneumatization with growth using 3D reconstructed computed tomography (CT) images. PATIENTS AND METHODS: Eighty-four temporal bones of 42 patients under the age of 16 years who had undergone head and facial bone CT were included in this retrospective study. The bony growth of the temporal bone and the head size were evaluated with horizontal- and vertical-plane CT images. Pneumatization of the temporal bone was investigated with 3D reconstruction software using axial CT images, dividing them as follows: medially, anterosuperiorly, posterolaterally, and inferiorly. Pneumatization of each individual part was compared with that of other parts and was also evaluated according to the aging process. RESULTS: The mean pneumatization was measured as 1696.7mm3 in patients aged under 2 years, 3609.1mm3 in those aged 2-4 years, 5351.1mm3 in those aged 5-7 years, 7295.9mm3 in those aged 8-10 years, 7797.5mm3 in those aged 11-13 years, and 8526.6mm3 in those aged 14-16 years. The degree of temporal bone pneumatization of each part was correlated with that of other parts (p<0.05). The volume of pneumatization increased with growth of the temporal bone and with aging. The degree of pneumatization of specific parts might be related to developmental periods. CONCLUSION: The pneumatization of one part might affect the pneumatization of other nearby parts, or all parts might be affected by the same driving force of pneumatization.

Clinical Analysis of Paper Patch Myringoplasty in Patients with Tympanic Membrane Perforations.

OBJECTIVE: The aims of our study were to evaluate the outcome of office-based paper patch grafting in tympanic membrane (TM) perforation regardless of the disease duration or etiology and to compare the clinical factors influencing the successful closure of perforation between the success and failure groups of paper patch myringoplasty. MATERIALS AND METHODS: This is a retrospective study of 114 patients that underwent paper patch myringoplasty in an outpatient setting (success group, 83 cases; failure group, 31 cases). Thirteen clinical factors with potential impact on the healing status of the TM were investigated: gender, age, laterality, etiology, duration of perforation, tinnitus, hearing loss, otorrhea, size and location of perforation, status of contralateral ear, ipsilateral findings of computed tomography, and duration of complete healing. The follow-up period was at least 1 year. RESULTS: The total success rate of paper patch grafting was 72.8%. The mean age of the failure group was significantly more higher than that of the success group. Significant differences in the etiology as well as in the history of otorrhea were found between the success and failure groups. There were no significant differences for any of the other factors between chronic and non-chronic perforations. CONCLUSION: The predictors of successful outcome were patient's age, etiology of perforation, and history of otorrhea. Clinicians can attempt paper patch myringoplasty first in younger patients, traumatic TM perforation cases, and in patients with no history of otorrhea. Paper patch grafting can also be considered before formal surgical myringoplasty in the case of small, dry, chronic TM perforations.