Post Otoplasty Keloids–Case Series and Report of Successful Treatment with Cryotherapy

Abstract

Background: Otoplasty is a corrective procedure used to reshape the ears, commonly performed on young individuals and even children to improve the appearance, shape, or angle of the ears. Post-otoplasty keloids are known complication of this procedure. Safe and effective treatments are needed for otoplasty induced posterior auricular keloids.

Objective: To review the clinical presentation and natural history of otoplasty induced keloids, and to propose non-surgical intervention with cryotherapy as primary treatment.

Material and methods: This is a retrospective study of 13 consecutive patients with post- otoplasty, posterior auricular keloids who were seen by the author in his keloid specialty practice. Medical records and photographs of the lesions were analyzed. Descriptive statistics are provided.

Intervention:Cryotherapy was the primary treatment for bulky keloids.

Results: Two patients had minimal keloid formation at the sites of otoplasty and were advised to primarily receive, or continue with, intra-lesional steroids. Eleven patients had bulky keloids and were offered cryotherapy as primary treatment. Nine patients consented to the treatment. Three patients are still receiving treatment and as of their last follow-up visit had achieved partial reduction in the mass of their keloids. Six patients completed their course of treatment and achieved desired results with complete or near-complete resolution of their keloids. One patient had minor recurrence and is now undergoing treatment.

Conclusions and Relevance:Using cryotherapy as primary intervention for bulky post-otoplasty keloids can successfully reduce the bulk of these lesions. Cryotherapy seems to not trigger the wound healing response to the extent that surgical scalpels do, therefore resulting in a much better therapeutic outcome. Additionally, cryotherapy is a much less morbid alternative to surgery. It is also less costly and very easy to administer in an out patient setting.