Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

A Fully Digital Auricular Splint Workflow for Post-Keloid Excision

  • Rahmat Maria (Department of Restorative Dentistry, National Dental Centre of Singapore) ;
  • Yee Onn Kok (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Khim Hean Teoh (Department of Restorative Dentistry, National Dental Centre of Singapore)
  • Received : 2023.03.23
  • Accepted : 2023.06.15
  • Published : 2023.11.15
Download PDF
⟨ Previous Next ⟩

Abstract

Ear keloids are challenging lesions to treat due to high recurrence rates postexcision. Conservative compression techniques as adjunct treatment have been reported to be effective. An innovative technique of using computer-aided design/computed-aided manufacturing to print a customized auricular splint improves efficiency and comfort level for patients compared with conventional methods. The ear is scanned using an intraoral scanning 2 weeks postsurgery. A two-piece auricular splint is designed on the digital model, incorporating perforated projections for three nylon screws for retention of the splint. The splint is printed with clear acrylic material, postprocessed, and finished. The patient is taught to assemble the components of the splint and instructed to wear for at least 8 hours daily. The surgery site reviewed for any ulceration, pain, or recurrence of keloid for 6 months. During the 6-month review, the excision scar remained flat and pink. The patient also reports unrestricted daily activities. The digital workflow increases comfort for the patient and reduces the number of hours required to produce a customized auricular splint compared with conventional methods. A fully digital workflow for a printed auricular splint should be considered for adjunctive treatment to excision of ear keloids.

Keywords

References

  1. Cosman B, Wolff M. Correlation of keloid recurrence with completeness of local excision. A negative report. Plast Reconstr Surg 1972;50(02):163-166 https://doi.org/10.1097/00006534-197208000-00011
  2. Berman B, Bieley HC. Adjunct therapies to surgical management of keloids. Dermatol Surg 1996;22(02):126-130 https://doi.org/10.1111/j.1524-4725.1996.tb00493.x
  3. Hassel JC, Loser C, Koenen W, Kreuter A, Hassel AJ. Promising results from a pilot study on compression treatment of ear keloids. J Cutan Med Surg 2011;15(03):130-136 https://doi.org/10.2310/7750.2011.10015
  4. Mercer DM, Studd DM. "Oyster splints": a new compression device for the treatment of keloid scars of the ear. Br J Plast Surg 1983;36(01):75-78 https://doi.org/10.1016/0007-1226(83)90017-6
  5. Olabanji JK, Onayemi O, Olasode OA, et al. Keloids: an old problem still searching for a solution. Surg Pract 2005;9:2-7 https://doi.org/10.1111/j.1744-1633.2005.00226.x
  6. Botwood N, Lewanski C, Lowdell C. The risks of treating keloids with radiotherapy. Br J Radiol 1999;72(864):1222-1224 https://doi.org/10.1259/bjr.72.864.10703484
  7. Epstein R, Hanham I, Dale R. Radiotherapy-induced second cancers: are we doing enough to protect young patients? Eur J Cancer 1997;33(04):526-530 https://doi.org/10.1016/S0959-8049(97)00056-7
  8. Ragoowansi R, Cornes PG, Glees JP, Powell BW, Moss AL. Ear-lobe keloids: treatment by a protocol of surgical excision and immediate postoperative adjuvant radiotherapy. Br J Plast Surg 2001;54(06):504-508 https://doi.org/10.1054/bjps.2001.3656
  9. Kadouch DJ, van der Veer WM, Mahdavian Delavary B, Kerkdijk D, Niessen FB. Therapeutic hotline: an alternative adjuvant treatment after ear keloid excision using a custom-made methyl methacrylate stent. Dermatol Ther 2010;23(06):686-692 https://doi.org/10.1111/j.1529-8019.2010.01374.x
  10. Park TH, Rah DK. Successful eradication of helical rim keloids with surgical excision followed by pressure therapy using a combination of magnets and silicone gel sheeting. Int Wound J 2017;14(02):302-306 https://doi.org/10.1111/iwj.12547
  11. Tanaydin V, Beugels J, Piatkowski A, et al. Efficacy of custom-made pressure clips for ear keloid treatment after surgical excision. J Plast Reconstr Aesthet Surg 2016;69(01):115-121 https://doi.org/10.1016/j.bjps.2015.09.013
  12. Li H, Song T. 3d printed custom made pressure clips for ear keloid treatment after surgical excision. Am J Otolaryngol 2020;41(04):102516
  13. Nejat AH, Hamdan S, Abrego I, Lindsey JT, Vitter R. Fully digital workflow for fabrication of a 3D printed ear stent for auricular keloids: a technique article. J Prosthodont 2022;31(03):266-270 https://doi.org/10.1111/jopr.13455