Objective The COVID-19 pandemic significantly altered healthcare utilisation and patient presentation patterns. This study investigates the impact of the pandemic on the incidence, complexity, and microbiology of deep neck space abscesses (DNSAs) over a nine-year period. Study design Retrospective analysis was conducted on DNSA admissions from January 2013 to May 2022. Setting Tertiary University Hospital in South England. Methods A retrospective analysis was conducted on DNSA admissions at a tertiary University Hospital in South England from January 2013 to May 2022. Patients were categorised into pre-pandemic (2019 and earlier) and peri-/post-pandemic (2020–2022) groups. Outcomes measured included DNSA incidence, complication rates, and microbiological profiles. Statistical significance was assessed using independent two-tailed t-tests (p<0.05). Results A total of 51 DNSA cases were identified, with a significant increase in admissions during and after the pandemic compared to pre-pandemic years (28/51 vs. 23/51, t=4.852, p=0.001268). DNSA complexity also rose post-pandemic, with higher rates of complications such as abscess re-collection and mediastinitis (25/51 vs. 7/51, t=5.710, p=0.000449). Microbiological analysis revealed a notable increase in Streptococcus milleri and Streptococcus pyogenes (10/51 vs. 5/51, t=3.773, p=0.005443), as well as a greater prevalence of anaerobic bacteria. Conclusion The COVID-19 pandemic contributed to a significant rise in DNSA incidence and complexity, likely due to delayed healthcare-seeking behaviours and reduced primary care interventions. Changes in microbial patterns emphasise the need for robust antimicrobial stewardship. The findings underscore the importance of timely intervention and multidisciplinary management of DNSAs. Future research could explore the impact of pandemic-related healthcare disruptions on DNSA microbiology.

Prominent ears affect 5% of the population(1). For those who wish to undergo corrective surgery, pinnaplasty reduces pinna prominence. This has proven improvement on quality of life (QOL) for patients. Pinnaplasty carries risk, which may lead to delay in this improvement of QOL, if for example a complication leads to infection, or require surgical revision The use of Mustardé sutures for pinnaplasties, first described in 1963 is a well established surgical approach to treat protruding ears. This approach has good outcomes, however can lead to suture-extrusion. Here we explore the use of Biodesign surgical mesh to cover the Mustardé sutures to prevent suture extrusion, and reduce the likelihood of the need for revision surgery.