Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Ulm, Frauensteige 12, 89075, Ulm, Germany.
Eur Arch Otorhinolaryngol. 2010 Apr;267(4):575-80. doi: 10.1007/s00405-009-1059-8. Epub 2009 Aug 9.
The aim of this study was to present long-term results in patients with auricular keloids after surgical excision and/or medical therapy by corticoid injection. A retrospective study at an academic tertiary referral centre is presented. Seventeen patients after excision, injection of corticoid, full skin grafting (single therapy or combination of interventions) for auricular keloids were followed up. The validated questionnaires SF-36 and patient outcomes of surgery-head/neck were applied to evaluate the quality of life and the patients' satisfaction after therapy. Photographs of the former keloid site were rated by an experienced facial plastic surgeon being unaware of treatment method and the patient's own estimation. The best results for retroauricular keloids were reached by excision, skin grafting and triamcinolone injection, and for earlobe keloids by excision, primary wound closure and triamcinolone injection. Both in rating by the patients and in grading by an investigator, the highest scores for aesthetics and satisfaction were found after triamcinolone injection together with or without excision or skin grafting. A size-related resection of keloids with defect reconstruction by full thickness skin grafting for retroauricular keloids and primary wound closure of ear lobe keloids with an additional steroid injection lead to good cosmetic results and high level of satisfaction among patients.
本研究旨在展示外科切除和/或皮质类固醇注射医学治疗后耳廓瘢痕疙瘩患者的长期结果。介绍了一个学术性三级转诊中心的回顾性研究。对 17 例因耳廓瘢痕疙瘩接受切除、皮质类固醇注射、全厚皮片移植(单一疗法或联合干预)的患者进行了随访。采用经过验证的 SF-36 问卷和头颈部手术患者结局问卷评估治疗后的生活质量和患者满意度。由一位经验丰富的面部整形医生对以前的瘢痕疙瘩部位的照片进行评分,该医生不知道治疗方法和患者的自身估计。对于耳后瘢痕疙瘩,切除、植皮和曲安奈德注射的效果最好,对于耳垂瘢痕疙瘩,切除、一期缝合和曲安奈德注射的效果最好。无论是患者评分还是研究者评分,曲安奈德注射联合或不联合切除或植皮的美学和满意度评分最高。对于耳后瘢痕疙瘩,根据瘢痕疙瘩的大小进行相关切除,并采用全厚皮片移植进行缺损重建,对于耳垂瘢痕疙瘩,采用一期缝合,并额外进行类固醇注射,可获得良好的美容效果和高满意度。