Lee Jae Woo, Seo Kwang Sik, Oh Se-Joon, Kong Soo-Keun, Kim Seok Hyun, Lee Il Woo, Lee Hyun Min
Department of Plastic Surgery, Pusan National University College of Medicine, Pusan National University, Yangsan, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Republic of Korea.
Int J Pediatr Otorhinolaryngol. 2024 Feb;177:111858. doi: 10.1016/j.ijporl.2024.111858. Epub 2024 Jan 14.
Preauricular sinus (PAS) is a congenital anomaly that can progress to complicated cases with granulation tissue around the PAS area due to skin inflammation. Treatment involves incision and drainage or continuous dressing; however, surgical treatment may be necessary. We evaluated a surgical method for the effective treatment of complicated PAS.
We retrospectively reviewed the medical records of 152 patients with PAS who were treated at a tertiary medical institution between September 2015 and June 2022. Data regarding age, sex, preoperative history related to PAS, a joint operation with a plastic surgeon, operation time, admission duration, follow-up duration, and postoperative complications were collected. The study population was divided into single-excision and double-excision with coaptation suture groups. The clinical characteristics were analyzed and compared between the two groups.
Surgical treatment for PAS was performed in 131 patients (166 ears) in the single-excision group and 21 patients (27 ears) in the double-excision group. The average age was 6.22 ± 4.06 years old, and the male-to-female ratio was similar in the single-excision group (M:F = 68:63) but higher for females in the double-excision group (M:F = 5:16) (p = 0.017). Joint surgeries with a plastic surgeon were more frequent in the double-excision group, and the operation time and admission duration were significantly longer. The preoperative history and postoperative complications (seven cases, 4.6 %) did not differ significantly between the two groups, although there was a higher percentage of complications in the double elliptical excision group.
Double excision with one or more coaptation sutures is an effective one-step method for complicated PAS with an acceptable aesthetic appearance of the scar, although it requires a longer operation time and admission duration for wound care. Further studies with larger and more diverse patient populations are needed to validate these findings.
耳前窦道（PAS）是一种先天性异常，由于皮肤炎症，可发展为PAS区域周围有肉芽组织的复杂病例。治疗方法包括切开引流或持续换药；然而，可能需要进行手术治疗。我们评估了一种有效治疗复杂PAS的手术方法。
我们回顾性分析了2015年9月至2022年6月在一家三级医疗机构接受治疗的152例PAS患者的病历。收集了年龄、性别、与PAS相关的术前病史、与整形外科医生联合手术、手术时间、住院时间、随访时间和术后并发症等数据。研究人群分为单次切除组和双次切除并拉拢缝合组。分析并比较两组的临床特征。
单次切除组131例患者（166耳）和双次切除组21例患者（27耳）接受了PAS手术治疗。平均年龄为6.22±4.06岁，单次切除组男女比例相似（男：女=68：63），但双次切除组女性比例更高（男：女=5：16）（p=0.017）。双次切除组与整形外科医生联合手术更为频繁，手术时间和住院时间明显更长。两组术前病史和术后并发症（7例，4.6%）差异无统计学意义，尽管双椭圆形切除组并发症发生率更高。
一次或多次拉拢缝合的双次切除是治疗复杂PAS的有效一步法，瘢痕外观可接受，尽管伤口护理需要更长的手术时间和住院时间。需要对更大、更多样化的患者群体进行进一步研究以验证这些发现。
