Cader Segana Hasan Abdul, Shah Fahim Ahmed, Reghunandanan Nair S K G
Department of ENT, Sur Hospital, South Sharqiya Region. Sur, Oman.
World J Otorhinolaryngol Head Neck Surg. 2018 Oct 17;4(4):234-239. doi: 10.1016/j.wjorl.2018.08.002. eCollection 2018 Dec.
An auricular pseudocyst is not uncommon in routine ENT clinical practice, it occurs when fluid accumulates between the intracartilaginous spaces of the auricle. Many treatment modalities have been proposed such as incision and drainage of the cyst, simple needle aspiration, tight bandaging with dental rolls, however recurrence and cosmetic problems are still noted in some cases. The aim of this article was to discuss our experience of surgical treatment of intractable auricular pseudocysts with marsupialisation, deroofing and anterior cartilage leaflet removal along with compression suture therapy.
Twenty patients were included in the study conducted at ENT department, Sur Ministry of Health Hospital between January 2012 and January 2014 after prior consent and ethical approval. Those following trauma and other pinna conditions like relapsing polychondritis were excluded from our study. The clinical appearances were noted and all patients underwent surgical deroofing with removal of anterior cartilage leaflet and compression suture therapy using buttons for two weeks.
There were 8 males and 12 females out of the 20 and right sided pinna ( = 14) involvement in the region of the scaphoid fossa ( = 12) was more than the triangular fossa ( = 3) or conchal bowl involvement ( = 5). Mostly patients between 30 and 40 years of age were affected (Mean age of 37 years and standard deviation of 8). The overall success rate with deroofing and compression suture therapy was 98%.
Auricular pseudocysts are not an uncommon condition affecting middle aged patients without identifiable etiology. Conservative modalities may be the first choice of treatment for auricular pseudocysts although varied recurrence and failure rates have been published in the literature. However, the deroofing surgical technique with anterior cartilage leaflet removal with compression suture therapy is a reliable and easy procedure which can achieve an acceptable appearance of the pinna without recurrence when conservative management fails or is refused by the patient.
耳廓假性囊肿在耳鼻喉科日常临床实践中并不少见，它是由于液体在耳廓软骨内间隙积聚而形成的。已经提出了许多治疗方法，如囊肿切开引流、单纯针吸、用牙卷紧密包扎等，但在某些情况下仍存在复发和美容问题。本文的目的是讨论我们采用造袋术、去顶术、切除前软骨瓣并结合压迫缝合治疗顽固性耳廓假性囊肿的经验。
2012年1月至2014年1月期间，在卫生部医院耳鼻喉科进行的一项研究纳入了20例患者，研究前获得了患者的同意并经过了伦理批准。排除有外伤史以及患有其他耳廓疾病（如复发性多软骨炎）的患者。记录临床症状，所有患者均接受了去顶手术，切除前软骨瓣，并使用纽扣进行两周的压迫缝合治疗。
20例患者中，男性8例，女性12例，右侧耳廓（n = 14）受累，舟状窝区域（n = 12）受累多于三角窝（n = 3）或耳甲腔受累（n = 5）。大多数患者年龄在30至40岁之间（平均年龄37岁，标准差8岁）。去顶术和压迫缝合治疗的总体成功率为98%。
耳廓假性囊肿是一种影响中年患者且病因不明的常见疾病。保守治疗方法可能是耳廓假性囊肿的首选治疗方法，尽管文献中报道了不同的复发率和失败率。然而，切除前软骨瓣并结合压迫缝合的去顶手术技术是一种可靠且简便的方法，当保守治疗失败或患者拒绝时，可以使耳廓外观达到可接受的效果且不复发。
