Novel Compression Devices for Ear Keloid Management: A Clinical Case Series

Background: Auricular keloids and ear helix deformities are undesirable and aesthetically unpleasing deformities that can cause significant patient psychologic and self-esteem problems. Pressure therapy for keloids is well documented to be an effective non-invasive treatment modality. However, current devices lack comfort and aesthetic appeal to deliver the pressure forces required effectively and uniformly. This work aims to highlight some different pressure therapy approaches for the management of keloids and irregularities in the ear helix morphology. Methods: A case series of four patients presenting with auricle keloids of various sizes and at different locations secondary to ear piercing and one case of congenital helix deformity were treated successfully with pressure therapy devices. The device designs varied based on the keloids’ characteristics and patients’ preferences and involved wire-based spring-activated appliances resembling ear rings for moderate keloid lesions, modified double-spring systems for large or elongated lesions, and magnet-based devices. A pair of inert magnetic discs of different diameters was positioned on the anterior and posterior aspects of the keloid lesion. The magnets were then encapsulated in acrylic resin to improve retention and adaptation, and the external surface was masked with gold glitter to enhance aesthetics and patient acceptance. The helix-deformity case was treated following a complete digital workflow integration where the sound contralateral ear was digitally scanned, mirror-imaged and then 3D-printed in resin to produce an ear model based on which an anatomically symmetrical pressure device was constructed. Results: All devices were successfully fitted and well tolerated, with no reported discomfort or adverse reactions. The wire spring devices were effective in reducing a large keloids volume; however, frequent reactivation every two weeks was required to ensure continuous pressure application. Incorporating magnets in the customised design allowed controlled and uniform pressure application to small keloid-lesion morphology, with enhanced aesthetics and improved patient acceptance and compliance. The digitally assisted case achieved near-perfect anatomical symmetry with the contralateral ear, reducing operator dependency and fabrication guesswork. Conclusions: Customised pressure therapy devices, of magnetic and spring-based systems, alongside utilising digital technologies, offer effective, non-invasive management for auricular keloids and irregular ear helices as long as the patient is committed to wearing the device.