Management of external ear keloids using form-pressure therapy

Abstract

Keloids are a frequent finding after physical trauma. Keloids of the pinna (helix and antihelix) as a complication of ear-piercing are the most difficult cases. Clinicians have tended to avoid the surgical approach, preferring local conservative treatment with corticosteroids or other treatments. We report use of intrakeloid resection and a form-pressure device to treat pinna keloids and avoid recurrence. The purpose is to maintain the form of the folds of the pinna. The recommendation for this therapy is to maintain the pressure at 24-30 mmHg, and the duration of the form-pressure therapy in our patients was about 25 weeks.

Surgical Management of a Case of Bilateral Auricular Keloids in an Adolescent Girl

“…These pressure devices modulate collagen metabolism by producing a hypoxic environment by application of pressure exceeding the capillary pressure, thus causing fibroblastic degradation and necrosis. Application of a controlled and continuous pressure of 24-30mm Hg, by an optimally aligned custom made appliance has been considered ideal [11,12]. A drawback of this treatment modality is a heavy reliance on patient compliance.…”

Role of Pressure Therapy in the Management of Earlobe Clefts

“…5,10 Numerous devices like ear pressure clips, cling on earrings, buttons, or silicon pressure packing can be used to provide pressure therapy. [1][2][3][4] The custom-made appliances are preferable attributing to the complex anatomy of the pinna, which interferes with the alignment of the appliance and the provision of adequate pressure. [1][2][3][4] The mechanism of action of the pressure appliance is still unclear.…”

“…[1][2][3] It is a kind of conservative and minimally invasive treatment that involves the use of prefabricated or custom-made clips, buttons, and earrings. [1][2][3] Pressure therapy along with intralesional steroid therapy may be used as a conservative nonsurgical treatment approach for the management of auricular keloids and to prevent recurrence. 4 Pressure therapy alone or as an adjuvant to surgery has shown good results in the management of auricular keloids.…”

“…4 Pressure therapy alone or as an adjuvant to surgery has shown good results in the management of auricular keloids. [1][2][3][4] Pressure therapy is used in presurgical stage (for reduction in size of lesion) and postsurgical stage (to prevent recurrence by softening the scar tissue). [1][2][3][4] Earlobe clefts can be either acquired or congenital.…”

“…[1][2][3][4] Pressure therapy is used in presurgical stage (for reduction in size of lesion) and postsurgical stage (to prevent recurrence by softening the scar tissue). [1][2][3][4] Earlobe clefts can be either acquired or congenital. 5 Acquired clefts or splitting of earlobe can be afflicted by the wearing of heavy earrings for a prolonged duration or by sudden traumatic injuries like sudden pulling of earring by a child or a snatcher.…”