Combination Between Surgical Excision and Pressure Therapy for Ear Keloids in a Pediatric Population: Clinical Results

Abstract

Introduction: A single effective therapeutic option for ear keloids has yet to be discovered. Many treatments have been studied with variable effectiveness, side effects and complications. Pressure therapy using custom molded clip is a non-invasive treatment with minimal side effects. In the present study, the recurrence rate of a treatment protocol combining excisional surgery and pressure therapy on ear keloids is being studied in a pediatric population. Materials and Methods: The charts of 22 consecutive patients treated between January 2008 and January 2019 were reviewed. All patients were under 18 years of age and clinically diagnosed with, at least, one keloid of the ear. They all underwent complete surgical excision with primary closure followed by early postoperative pressure therapy using custom molded clips. The collected data included patient age at time of diagnosis and surgery, sex, skin type, familial and personal history, etiology and anatomical location of the keloid, and recurrence. Patients or parents were interviewed by phone call and reviewed by an independent examiner to evaluate the current evolution of their scar (s). Results: 22 patients were included in the study, representing a total of 26 keloids of the ear. The male to female ratio was of 3:4. The mean age at diagnosis was 9.7 years old. The mean follow-up time was 5.2 years. Four ears needed a single corticoid injection in addition to the initial protocol. Follow-up observations showed a recurrence rate of 15.4%. Conclusion: Excisional surgery combined with pressure therapy is an effective and well-tolerated treatment for ear keloids in a pediatric population. Although residual symptoms are sometimes observed, it seems to be better tolerated than other, more invasive, therapies.