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J Audiol Otol. 2018 Jul;22(3):160-166. doi: 10.7874/jao.2018.00101. Epub 2018 Jun 14.

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

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Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.


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.


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."


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.


Hair removal; Otologic surgical procedures; Preoperative care; Surgical wound infection

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