耳廓瘢痕联合窦道切除术治疗耳部瘢痕疙瘩的疗效观察

Outcomes of Complete Scar Resection with Fistulectomy for Postpiercing Auricular Keloids

目的明确联合窦道完全切除瘢痕组织术治疗穿耳洞引起的耳部瘢痕疙瘩的治疗效果。方法回顾性分析2014年1月~2018年8月深圳市人民医院耳鼻咽喉头颈外科诊治的所有穿耳洞引起的耳部瘢痕疙瘩患者的临床资料,采用联合窦道完全切除瘢痕组织术,若瘢痕疙瘩体积较大则保留部分瘢痕疙瘩表皮瓣修复创面,行无张力缝合,术后半年每3~4周复诊1次,对有复发倾向者及时补充糖皮质激素局部注射治疗,观察治疗后效果。结果28例患者(32耳)完成随访1年以上,治愈25例(29耳),治愈率90.6%,有效2例(2耳),总有效率96.9%,复发1例(1耳),复发率3.1%。结论联合窦道完全切除瘢痕组织术能有效提高穿耳洞引起的耳部瘢痕疙瘩的有效率和降低复发率。

Objective To identify the efficacy of Complete Scar Resection with Fistulectomy for postpiercing auricular keloids.Methods In this retrospective cohort study,28 patients(32 ears)with auricular keloids after piercing were included,they were treated by Complete Scar Resection with Fistulectomy at Shenzhen People’s Hospital from January 2014 to August 2018.If the keloids were too large to be sutured with tension-free after total resection,partial skins on the surface of the keloids were remained as flaps to close the wound with free tension.After surgery,all patients were asked for a recheck each 3~4 weeks within 6 months,then the return period was changed to 3 months,as the wounds had signs of recurrence,intralesional steroid injection was at once administered and continued monthly for several months based on the patients’clinical progress.Then the treatment outcomes were evaluated at the last follow-up.Result 28 cases with 32 auricular keloids were followed up more than one year,the average follow-up was 36.9 months,25 cases with 29 auricular keloids were completely resolved,the cure rate was 90.6%,and 2 cases with 2 auricular keloids were improved,so the total effective rate was 96.9%,1 case with 1 auricular keloid was recurred,the recurrence rate was 3.1%.Conclusion Complete Scar Resection with Fistulectomy is a effective way to treat postpiercing auricular keloids with a satisfactory cure rate and a low recurrence rate.