George Shajul, George Shibu, Madhavan Rajeev Kumar, Asha C S
Department of ENT, Government Medical College, Gandhinagar, Kottayam, India.
Indian J Otolaryngol Head Neck Surg. 2025 Jan;77(1):22-33. doi: 10.1007/s12070-024-05085-w. Epub 2024 Oct 14.
A systematic review of literature on treatment modalities available with respect to efficacy, complications and recurrences so as to guide the clinician to better treat this enigmatic condition. A systematic search of PubMed, Google Scholar, Ovid and Cochrane databases. Articles in English that described or compared treatment were included. Articles without clear treatment end-points or follow-up data were excluded. Patients were then divided by primary treatment modality into Aspiration, Incision & Drainage (I&D), surgical deroofing, intralesional steroids (ILS) and No treatment groups and compared with respect to cure rates, complications and residual thickening using Chi-square test. Similarly confounding variables compression and suturing were compared. 85 articles were selected and reviewed (1699 patients; mean follow-up 7.8 months). Surgical deroofing had the highest cure rate (98.2%) followed by I&D (95.4%), both of which were significantly more efficacious than Aspiration with or without ILS ( < 0.001). Aspiration with ILS had the highest rate of complications (13.6%) and residual thickening (16.7%); significantly more than other treatment modalities. Aspiration with negative pressure device had a 100% cure in the few reported articles (n = 57). Compression had no significant advantage overall, but suturing significantly increased cure rates. Surgical deroofing and I&D are the most efficacious treatments. Aspiration + ILS has lower cure and significantly increased complications, hence should be avoided. Based on the results, we propose a treatment protocol for auricular pseudocyst. As only two high-quality randomized controlled trials were available in literature, further research in comparing treatment is warranted.
对现有治疗方式在疗效、并发症和复发方面的文献进行系统综述，以指导临床医生更好地治疗这种疑难病症。对PubMed、谷歌学术、Ovid和Cochrane数据库进行系统检索。纳入描述或比较治疗方法的英文文章。排除没有明确治疗终点或随访数据的文章。然后将患者按主要治疗方式分为抽吸组、切开引流（I&D）组、手术去顶组、病灶内注射类固醇（ILS）组和未治疗组，并使用卡方检验比较治愈率、并发症和残留增厚情况。同样，对混杂变量压迫和缝合进行比较。共筛选并回顾了85篇文章（1699例患者；平均随访7.8个月）。手术去顶的治愈率最高（98.2%），其次是切开引流（95.4%），这两种方法均比单独或联合ILS的抽吸治疗显著更有效（<0.001）。联合ILS的抽吸并发症发生率最高（13.6%），残留增厚率也最高（16.7%）；显著高于其他治疗方式。在少数报道的文章（n = 57）中，使用负压装置抽吸的治愈率为100%。压迫总体上没有显著优势，但缝合显著提高了治愈率。手术去顶和切开引流是最有效的治疗方法。抽吸 + ILS治愈率较低且并发症显著增加，因此应避免使用。基于这些结果，我们提出了一种耳廓假性囊肿的治疗方案。由于文献中仅有两项高质量的随机对照试验，因此有必要进一步开展比较治疗方法的研究。
