A novel negative pressure drainage treatment of auricular pseudocyst

A Systematic Review of Treatment Protocols in Auricular Pseudocysts

A systematic review of literature on treatment modalities available with respect to efficacy, complications and recurrences so as to guide the clinician to better treat this enigmatic condition. A systematic search of PubMed, Google Scholar, Ovid and Cochrane databases. Articles in English that described or compared treatment were included. Articles without clear treatment end-points or follow-up data were excluded. Patients were then divided by primary treatment modality into Aspiration, Incision & Drainage (I&D), surgical deroofing, intralesional steroids (ILS) and No treatment groups and compared with respect to cure rates, complications and residual thickening using Chi-square test. Similarly confounding variables compression and suturing were compared. 85 articles were selected and reviewed (1699 patients; mean follow-up 7.8 months). Surgical deroofing had the highest cure rate (98.2%) followed by I&D (95.4%), both of which were significantly more efficacious than Aspiration with or without ILS (p < 0.001). Aspiration with ILS had the highest rate of complications (13.6%) and residual thickening (16.7%); significantly more than other treatment modalities. Aspiration with negative pressure device had a 100% cure in the few reported articles (n = 57). Compression had no significant advantage overall, but suturing significantly increased cure rates. Surgical deroofing and I&D are the most efficacious treatments. Aspiration + ILS has lower cure and significantly increased complications, hence should be avoided. Based on the results, we propose a treatment protocol for auricular pseudocyst. As only two high-quality randomized controlled trials were available in literature, further research in comparing treatment is warranted.

Treatment of auricular pseudocysts using enhanced negative drainage: a prospective study of 21 cases

OBJECTIVE

Auricular pseudocysts are rare, painless, benign intracartilaginous cysts of the auricle that are not lined by epithelium and have no known aetiology.

METHOD

This was a prospective study conducted in an ENT department from January 2020 to June 2022. In 21 patients, complete aspiration of the pseudocyst with enhanced negative drainage was performed. They were followed for a minimum of six months.

RESULTS

All patients completely responded to the negative drainage treatment. No cases of recurrence or obvious deformities were observed.

CONCLUSION

Aspiration with intensified negative drainage was associated with a positive response in patients with auricular pseudocysts. Complete resolution of the swelling can be achieved without any serious complications. Thus, it appears to be a simple and effective method for managing the condition.

Negative Pressure Wound Therapy in the Head and Neck: A Summary of Uses and Application Techniques

Negative pressure wound therapy (NPWT) has had an expanded role in the management of complex wounds including its increasing use for complex wounds in the head and neck region. Challenges for use in the head and neck region include variations in surface topography and the proximity of sensitive mouth, nose, ear, eye, and tracheal openings. Despite these challenges, NPWT has been used in the head and neck immediately following free flap surgery, to prepare wounds for skin grafting or local flaps, to treat orocutaneous and pharyngocutaneous fistulas, to treat necrotizing and deep neck space infections, to temporize and palliate, and to treat chronic wounds with exposed bone and hardware among others. This review demonstrates the proven track record of successful uses of NPWT in the aforementioned scenarios, provides suggestions to improve efficacy, as well as an algorithm for use in certain clinical situations.