Is a head bandage useful after otoplasty? A quasi-randomized controlled study of complications and patient satisfaction

September 30, 2009
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We conducted a prospective, quasi-randomized, controlled study to evaluate the incidence of postoperative complications and the degree of long-term patient satisfaction associated with the use or nonuse of a head bandage following otoplasty (pinnaplasty). Our study population was made up of 84 consecutively presenting patients who had undergone bilateral otoplasty (either an antihelical or conchaplasty procedure) for the correction of prominent ears under general anesthesia from January 2000 through March 2005. Patients ranged in age from 5 to 56 years (median: 13); 69 patients (82%) were aged 19 years and younger. Of the 84 patients, 61 (73%) received a postoperative head bandage and 23 (27%) did not. Data on complications were collected prospectively from case notes. Data on long-term satisfaction were obtained prospectively on the basis of answers to a questionnaire survey (90% response rate) in which patients rated their satisfaction on a visual analog scale from 0 (not at all satisfied) to 10 (completely satisfied). We found no significant difference between the head-bandage group and the no-head-bandage group with respect to complication rates (36 and 26%, respectively; p = 0.3) or long-term patient satisfaction scores (6.56 and 8.46; p = 0.09). According to multiple regression analysis, the performance of conchaplasty (as opposed to antihelical procedures) appeared to be the only independent variable that influenced both of the outcomes measures (i.e., fewer complications and greater long-term patient satisfaction). Two independent variables were found to influence long-term patient satisfaction only: the presence/absence of any complication and the individual surgeon who performed the procedure. There was no correlation between individual surgeons and complications. We conclude that the use of a head bandage is not necessary or advantageous following otoplasty for the correction of prominent ears, particularly in patients who have undergone cartilage plication.

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