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Laryngorhinootologie 2019; 98(08): 536-544
DOI: 10.1055/a-0960-6100
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Keloidbehandlung mit intraläsionaler Kryochirurgie

Eine Differenzierung der Keloidformen zur Verbesserung der PatientenselektionIntralesional Cryosurgery in the Treatment of KeloidsA Differentiation of Keloid Types for the Improvement of Patient Selection
C. C. Zouboulis
1   Klinik für Dermatologie, Venerologie und Allergologie/Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane, Dessau
,
M. J. Weidmann
2   Praxis Dr. Weidmann und Kollegen, Augsburg
,
Y. Har-Shai
3   Unit of Plastic Surgery, Carmel Medical Center and The Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
› Author Affiliations
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Publication History

Publication Date:
06 August 2019 (online)

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Zusammenfassung

Die Überproduktion veränderter Kollagenfasern und die Überexpression von Tumor-Growth-Factor-β muss gehemmt werden, um den Wachstumsprozess innerhalb einer Keloidnarbe zu unterbrechen. Dies kann mit den klassischen Therapieverfahren kaum gelingen. Die Behandlungsergebnisse der Keloidtherapie sind nur schwer vorherzusagen und die Rezidivrate liegt meist über 50 %. Darüber hinaus können einige der eingesetzten Verfahren (z. B. Bestrahlung) zusätzliche gesundheitliche Risiken verursachen. Die intraläsionale Kryochirurgie bietet eine seit nunmehr 10 Jahren erprobte Therapiealternative an. Eigene Ergebnisse von weit über tausend Behandlungen von Patienten mit Keloiden ermöglichen eine kritische Analyse, um eine Unterscheidung der Keloide, die gut zu behandeln sind, von denen, die sich für eine Behandlung weniger oder gar nicht eignen, treffen zu können.

Abstract

The overproduction of altered collagen fibers and the overexpression of Tumor Growth Factor-β must be blocked in order to interrupt the growth process within a keloid scar. This can barely be achieved with the classical therapeutic methods. The results of keloid treatment are difficult to predict and the recurrence rate is usually over 50 %. In addition, some of the procedures used (e. g. irradiation) may induce additional health risks. Intralesional cryosurgery offers a therapeutic alternative that has been evaluated since more than a decade. Our own experience in more than one thousand keloid treatments allows a critical evaluation of the classification in those keloid types, which are recommended to be treated with the technique and those, which may not respond.

 

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