Department of Otorhinolaryngology, Afyonkarahisar Şuhut State Hospital, Afyonkarahisar, Turkey.
Am J Otolaryngol. 2021 May-Jun;42(3):102935. doi: 10.1016/j.amjoto.2021.102935. Epub 2021 Jan 22.
Ear keloids lead to psychological problems in the patient by causing complaints, such as itching and swelling. It is highly resistant to treatment, and recurrences are frequent. In the present study, the purpose was to investigate the treatment success of the intralesional steroid and PRP combination in addition to surgical excision in ear keloids. The 5-year recurrence rates and adverse effects of both treatments were also compared in this respect.
In this study, 60 patients between the ages of 16 and 65 who were followed up between 2015 and 2020 due to ear keloids were evaluated retrospectively. Patients were divided into 3 different groups (n = 20) as (A-B-C). There were patients who had only intralesional steroid injections due to ear keloids in Group A, patients who had intraoperative/postoperative steroid injections combined with surgical excision were in Group B, and patients who had intraoperative/postoperative steroid+intraoperative Platelet-Rich Plasma (PRP) injections combined with surgical excision were in Group C.
It was found that the 5-year recurrence rate was the lowest in Group C (Surgical Excision+PRP + TAC). The 5-year recurrence rate of Group C was significantly lower when compared with other groups (p < 0.05). When the 5-year recurrence rate of Group A (TAC) and B (Surgical Excision+TAC) was compared, the recurrence rate of Group B was significantly lower (p < 0.05). When the adverse effects were compared, no significant differences were detected between two Groups (A-B) in terms of Skin Atrophy and Telangiectasia. Significant differences were detected between patients in Group C and other groups (p < 0.05). No significant differences were detected between Group B and C (p = 0.832).
The combination of surgical excision with Intralesional TAC and PRP treatment in patients with ear keloids should be considered as a highly successful multimodal treatment in terms of low recurrence and adverse effects.
耳部瘢痕疙瘩会导致患者出现瘙痒和肿胀等投诉，从而导致心理问题。它对治疗具有高度抗性，并且经常复发。本研究旨在调查除手术切除外，局部皮质类固醇和 PRP 联合治疗耳部瘢痕疙瘩的治疗成功率。在这方面，还比较了两种治疗方法的 5 年复发率和不良反应。
在这项研究中，回顾性评估了 2015 年至 2020 年间因耳部瘢痕疙瘩而接受随访的 60 名年龄在 16 岁至 65 岁之间的患者。患者分为 3 个不同的组（n=20），即（A-B-C）。组 A 中的患者仅因耳部瘢痕疙瘩接受局部皮质类固醇注射，组 B 中的患者在手术切除后接受皮质类固醇注射，组 C 中的患者在手术切除后接受皮质类固醇+术中富含血小板的血浆（PRP）注射。
发现组 C（手术切除+PRP+TAC）的 5 年复发率最低。与其他组相比，组 C 的 5 年复发率显著降低（p<0.05）。当比较组 A（TAC）和 B（手术切除+TAC）的 5 年复发率时，组 B 的复发率显著降低（p<0.05）。当比较不良反应时，组 A 和 B 之间在皮肤萎缩和毛细血管扩张方面没有发现显著差异。组 C 与其他组之间存在显著差异（p<0.05）。组 B 和 C 之间没有发现显著差异（p=0.832）。
对于耳部瘢痕疙瘩患者，手术切除联合局部 TAC 和 PRP 治疗应被视为一种低复发率和低不良反应的高度成功的多模式治疗方法。
