Uso de imanes en el tratamiento de queloides auriculares / Magnets use in the treatment of ear keloids

Introducción y Objetivos. La incidencia de queloides auriculares es cada vez mayor. Su alta frecuencia de recidiva es de gran interés, por ello su extirpación quirúrgica se asocia a otras terapias como radioterapia, corticoides, crioterapia, láser, presoterapia, etc. La presoterapia resulta un método efectivo, sencillo y accesible. Material y Método. Realizamos un estudio prospectivo, experimental, sobre 11 casos de queloides auriculares tratados con resección quirúrgica seguida de presoterapia usando imanes, tomando en cuenta la presión y fuerza magnética ejercida. Llevamos a cabo seguimiento de los casos entre 4 y 6 meses. Empleamos las pruebas de Mann-Whitney y Coeficiente Lineal de Pearson. Determinamos la tasa de recurrencia y realizamos un análisis de regresión para el estudio de la escala de Valor Análoga del Dolor (EVA). Resultados. La tasa libre de recurrencia fue del 90.91%. No hubo ningún tipo de complicación. En cuanto a la EVA, observamos una ascendente tolerancia a la terapia con imanes auriculares a través del tiempo. Conclusiones. El protocolo de uso de imanes que presentamos es un excelente tratamiento coadyuvante. El magnetismo parece cumplir un papel fundamental en la remodelación y organización de las fibras de colágeno de las cicatrices postoperatorias, añadiendo una efectividad mayor a la presoterapia (AU)

Background and Objective. The incidence of keloids in ears is increasing. The high frequency of recurrence is of great interest, so surgical removal is associated with other therapies like radiotherapy, corticosteroids, cryotherapy, laser, acupressure, etc. Pressure therapy is an effective, simple and accessible method. Methods. We conduct a prospective, experimental study, with 11 cases of keloid ears treated with surgical resection followed by pressure therapy using magnets, taking into account the pressure and magnetic force. Follow up between 4 and 6 months was performed. Tests such as Mann-Whitney and Linear Coefficient were used. The recurrence rate was determined and a regression analysis to study the value in Analog Scale of Pain (VAS) was performed. Results. The recurrence free rate was 90,91%. There were no complications. As the EVA, an upward tolerance headset magnet therapy over time was observed. Conclusions. The protocol we present using magnets is an excellent adjuvant treatment. Additionally, magnetism seems to fulfill a key role in the remodeling and organization of the collagen fibers of postoperative scarring, adding more to this type of pressure therapy effectiveness (AU)

Reconstrucción de lóbulo rasgado incompleto mediante media z plastia o colgajo en hamaca / Incomplete cleft earlobe reconstruction using a z-plasty or hammock flap

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Audiologic changes after pinna augmentation.

No studies to date have objectively assessed whether pinna morphology affects sound intensity detected within the external auditory canal (EAC). Commonly performed procedures on the EAC are carried out for acquired and congenital pathology, together with correction of ear deformities. Our aim was to use an experimental model to identify whether a relationship exists between pinna shape and its subsequent effect on the hearing subject. An anatomically accurate and life-size model made of rubber composite was used for this study. Serial sections (small wedge, defect open; small wedge, defect closed; large wedge, defect open; large wedge, defect closed [equivalent to a protruding ear]; and pinnectomy) were undertaken, and the sound intensity changes assessed at the junction between the EAC and middle ear (tympanic membrane position) using an AURICAL Plus (Otometrics; Taastrup, Denmark) sound processor. A statistically significant loss was demonstrated for wedge-excised models, which was greatest at 180° azimuth. This loss was significantly reduced when the wedge defects were closed. A statistically significant improvement was demonstrated in the protruding ("bat") ear model compared with the normal ear at 0° azimuth. In this model, gain in sound intensity is adversely affected by pinna wedge resection. Because this change may be increased in those with protruding ears, this factor is important to consider for all cosmetic and noncosmetic operations to the pinna, and it supports the notion that the pinna is not a simple funnel.

Blood flow dynamics in reconstructed auricles.

Ear reconstruction with autologous rib cartilage is performed in stages. Restitution of blood flow between the separate stages is crucial to obtain a good result. Laser Doppler perfusion imaging (LDPI) and local temperature were measured in reconstructed and normal ears in response to indirect heating. Ten persons who had had a unilateral ear reconstruction were included in the study. At a minimum, 157 days had passed since the last operation. LDPI showed no difference in blood flow between the reconstructed ear and the normal ear, neither before nor after indirect heating. The upper part of the normal ear was slightly cooler than the corresponding part in the reconstructed ear. Indirect heating caused an increase of LDPI-values and temperatures in the upper, middle, and lower part of the ear both in the reconstructed ear and the normal one. Skin blood flow recovers after 3-stage ear reconstruction and shows normal dynamic response upon indirect heating.