Jones Michael E, McLane Jennifer, Adenegan Rachael, Lee JoAnne, Ganzer Christine A
*Lexington Plastic Surgeons, New York, New York; †Hunter-Bellevue School of Nursing, Hunter College, New York, New York.
Dermatol Surg. 2017 Sep;43(9):1164-1169. doi: 10.1097/DSS.0000000000001145.
BACKGROUND/OBJECTIVE: Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing.
Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects.
Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence.
Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear.
背景/目的：耳廓瘢痕疙瘩的治疗，尤其是发生在耳轮、对耳轮和耳垂部位，作为穿耳洞并发症出现的瘢痕疙瘩。
对49例患者进行回顾性分析，这些患者接受了耳廓瘢痕疙瘩的病灶外手术切除，随后在伤口部位应用自体富血小板血浆（PRP）并进行术后门诊浅表放射治疗（SRT）。放射治疗方案包括1至3次分割，累积剂量范围为1300至1800 cGy。平均随访24个月以评估复发证据和不良副作用。
采用该方法治疗了50个耳部瘢痕疙瘩，年龄在15至66岁之间（平均=32，标准差=16），其中男性14例，女性35例。近30%（n = 14）的患者承认导致瘢痕疙瘩形成的损伤来源是穿耳洞。治疗方案的成功率为94%，有3例患者报告复发。
手术切除联合术中PRP及术后辅助门诊SRT在2年随访期内实现了94%的无复发率。结果提供了初步的、尽管有力的证据，支持这种多模式方法作为耳部局限性瘢痕疙瘩管理的可行替代方案。
