Di Pierro Francesco, Loh Sean Bo Jie, Chua Nevin Yi Meng, D'Souza Ayman Alwyn, Ng Chew Lip
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Yong Loo Ling School of Medicine, National University of Singapore, Singapore.
Facial Plast Surg. 2025 Sep 2. doi: 10.1055/a-2689-1591.
Auricular keloids, particularly in the upper third of the ear, often recur after treatment and can cause aesthetic and functional deformities. This study assesses the effectiveness of stellate excision in reducing recurrence and improving cosmetic outcomes.Stellate excisions evolved from 19th-century wedge excisions, refined by 1960s otoplasty techniques to preserve ear shape and prevent deformities. Traditional skin flap techniques frequently show high recurrence rates and can compromise auricular contour, leading to unsatisfactory results.The ear, and specifically the upper third, is a challenging site for keloids due to its characteristic anatomy and susceptibility to mechanical stress during healing.Stellate excision allows for precise resection of keloids with back cuts and wedge extension to preserve ear shape and reduce tension.Forty adult patients with upper third keloids were retrospectively studied. All underwent stellate excision and standardized steroid injection follow-up.Complete excision with cartilage wedge resection, local flap closure, and layered suturing was performed under local anesthesia.Triamcinolone injections were administered at 2, 4, and 8 weeks postoperatively; follow-up continued for 24 months.Stellate excision showed a 95% success rate; future studies should assess broader anatomical applicability.Stellate excision is a reliable and cosmetically favorable method for managing upper third ear keloids, with a low recurrence rate.
耳部瘢痕疙瘩，尤其是耳上三分之一处的瘢痕疙瘩，在治疗后常复发，并可导致美学和功能畸形。本研究评估星状切除术在降低复发率和改善美容效果方面的有效性。星状切除术由19世纪的楔形切除术发展而来，经20世纪60年代的耳整形技术改进，以保留耳朵形状并防止畸形。传统的皮瓣技术常常显示出高复发率，并且可能损害耳廓轮廓，导致结果不理想。由于其独特的解剖结构以及愈合过程中易受机械应力影响，耳朵，特别是上三分之一处，是瘢痕疙瘩的一个具有挑战性的部位。星状切除术通过背侧切口和楔形延伸允许精确切除瘢痕疙瘩，以保留耳朵形状并减轻张力。对40例患有耳上三分之一瘢痕疙瘩的成年患者进行了回顾性研究。所有患者均接受星状切除术和标准化的类固醇注射随访。在局部麻醉下进行软骨楔形切除、局部皮瓣闭合和分层缝合的完全切除。术后2周、4周和8周注射曲安奈德；随访持续24个月。星状切除术显示成功率为95%；未来的研究应评估更广泛的解剖学适用性。星状切除术是一种可靠且美容效果良好的方法，用于处理耳上三分之一的耳部瘢痕疙瘩，复发率低。
