Aljodah Mohammed Abd-Alhussein, Alfeehan Mohammed J, Al-Zajrawee Mustafa Zahi
Department of Surgery, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
Department of Surgery, College of Medicine, University of Anbar, Anbar, Iraq.
J Cutan Aesthet Surg. 2021 Oct-Dec;14(4):392-396. doi: 10.4103/JCAS.JCAS_186_20.
Auricular keloids that occur after ear piercing or other traumas can challenge surgeons as recurrence is frequent; there has been no consensus about the best management protocol. Surgical excision combined with perioperative corticosteroid injections is frequently used as first-line therapy, but recurrent auricular keloids are usually shifted to a combination of radiotherapy and surgical excision.
The objective is to evaluate the rate of recurrence when recurrent auricular keloids are treated with surgical excision with perioperative corticosteroid injections.
Between February 2017 and January 2020, 41 patients (52 auricles) with recurrent auricular keloids were treated by extralesional keloid excision combined with five corticosteroid steroid injections (two preoperative, one intraoperative, and two postoperative doses). Recurrence was recorded if the surgical scar showed hypertrophy or started to rise above the level of the margins.
The mean postoperative follow-up was 13.04 months (ranging from 6 to 24 months). Recurrence was recorded in five auricles (9.6%) during the follow-up period.
Perioperative corticosteroid injections combined with surgical excision of auricular keloids are still a valid option in recurrent cases, and it is a useful choice when radiotherapy facilities are limited.
穿耳洞或其他创伤后出现的耳廓瘢痕疙瘩会给外科医生带来挑战，因为复发很常见；对于最佳治疗方案尚无共识。手术切除联合围手术期皮质类固醇注射常被用作一线治疗方法，但复发性耳廓瘢痕疙瘩通常会转向放疗与手术切除相结合的治疗方式。
评估复发性耳廓瘢痕疙瘩采用手术切除联合围手术期皮质类固醇注射治疗后的复发率。
2017年2月至2020年1月期间，41例（52只耳廓）复发性耳廓瘢痕疙瘩患者接受了瘢痕疙瘩病灶外切除联合五次皮质类固醇注射治疗（术前两次、术中一次、术后两次）。如果手术瘢痕出现肥大或开始高于边缘水平，则记录为复发。
术后平均随访13.04个月（6至24个月）。随访期间有5只耳廓（9.6%）出现复发。
围手术期皮质类固醇注射联合耳廓瘢痕疙瘩手术切除在复发病例中仍是一种有效的选择，在放疗设备有限时是一种有用的选择。
