Luo Jing, Huang Jingyan, Yang Jun, Gao Zhen, Wang Xiuxia
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Aesthetic Plast Surg. 2025 Jun 5. doi: 10.1007/s00266-025-04925-6.
Auricular keloids are challenging to manage, and recurrent keloids are more aggressive and likely to cause auricular deformities. Monotherapy such as surgical resection, injection, or radiotherapy alone has a high recurrence rate. The treatment approach for auricular keloids remains to be investigated.
A retrospective analysis was conducted on 30 patients who received treatment at the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, between December 2021 and May 2023. Based on the size, location, and extent of keloid invasion, the appearance of auricle was reconstructed by repairing scar flap after excision of the keloid and its core or resection. Postoperative injections of triamcinolone were administered within one week after suture removal, followed by every two weeks for 4-6 times.
30 patients were followed up for 6-36 months after the operation. The POSAS score of the patients was significantly lower than that before the operation. Among them, one patient relapsed due to failure to receive regular postoperative injections, one patient experienced delayed healing due to local hair interference, and two patients had menstrual disorders during the injection.
For keloids with diverse morphologies and anatomic locations, adopting individualized combined treatment involving surgical excision and intralesional triamcinolone acetonide injections can achieve the reconstruction of auricle morphology and maintain a long-term therapeutic effect.
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耳部瘢痕疙瘩的治疗具有挑战性，复发性瘢痕疙瘩更具侵袭性，且可能导致耳部畸形。单纯手术切除、注射或放疗等单一疗法的复发率很高。耳部瘢痕疙瘩的治疗方法仍有待研究。
对2021年12月至2023年5月期间在上海第九人民医院整复外科接受治疗的30例患者进行回顾性分析。根据瘢痕疙瘩的大小、位置和侵袭范围，在切除瘢痕疙瘩及其核心或进行切除后，通过修复瘢痕皮瓣重建耳廓外观。术后在拆线后1周内注射曲安奈德，随后每2周注射1次，共注射4 - 6次。
30例患者术后随访6 - 36个月。患者的POSAS评分显著低于术前。其中，1例患者因未接受定期术后注射而复发，1例患者因局部毛发干扰导致愈合延迟，2例患者在注射期间出现月经紊乱。
对于形态和解剖位置各异的瘢痕疙瘩，采用手术切除和病灶内注射曲安奈德的个体化联合治疗可实现耳廓形态重建并维持长期治疗效果。
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