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Bone-Anchored Titanium Implants in Patients with Auricular Defects: Three Years and 27 Patients' Experience

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ABSTRACT

Different surgical solutions have been proposed for reconstruction of the auricle following loss of the pinna through traumatic injury or neoplastic disease or in patients with congenital defects. Surgical treatment may involve the insertion of an autogenous rib cartilage framework or the use of a porous polymer material inserted into an expanded postauricular flap. Reconstruction with rib cartilage has yielded good results but requires more than one surgical step, and adverse events can occur both at the donor and at the acceptor site; cases of prosthesis rejection have also been described following application of the polymeric prosthesis. The use of a titanium, dowel-retained silicone prosthetic pinna, fixed to the temporal bone, has recently been proposed. This useful surgical approach is indicated particularly after resection of the pinna caused by neoplastic disease or in traumatic auricular injury. Osseointegrated titanium implants used in 27 patients in this study provided them with a safe, reliable, adhesive-free method of anchoring the auricular prostheses. The prostheses allowed recovery of normal physical appearance and all the patients reported that they were completely satisfied with the outcome of the surgical reconstruction. No surgical complications, implant failures, or prosthetic failures were encountered over six months to three years.

No MeSH data available.


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Preoperative image of neoplastic amputation of left ear (a); the silicone epithesis created using a wax pattern (b); gold bar attached to two titanium implants (c); prosthetic pinna in place, clipped onto the gold bar (d).
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fig3: Preoperative image of neoplastic amputation of left ear (a); the silicone epithesis created using a wax pattern (b); gold bar attached to two titanium implants (c); prosthetic pinna in place, clipped onto the gold bar (d).

Mentions: Our case series comprised 27 patients (24 males and 3 females with a mean age of 33.1 years, range 16–87 years) (Table 1). The etiology was congenital in 17 patients (Figure 1) who were affected by microtia, while eight had posttraumatic mutilation (Figure 2) and two surgical amputation due to neoplasia (Figure 3). Six of the patients with microtia and three of the patients affected by traumatic mutilation had previously undergone plastic reconstructive surgery with rib cartilage grafting and were not satisfied with the results. These patients requested to have their previously reconstructed ear removed and replaced with an epithesis. One patient had previously undergone canaloplasty of the right external auditory meatus. One patient (patient 12) had previously undergone surgery, in a different hospital, using bone-anchored titanium implants but one of the abutments had broken because of a further unlucky trauma.


Bone-Anchored Titanium Implants in Patients with Auricular Defects: Three Years and 27 Patients' Experience
Preoperative image of neoplastic amputation of left ear (a); the silicone epithesis created using a wax pattern (b); gold bar attached to two titanium implants (c); prosthetic pinna in place, clipped onto the gold bar (d).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120180&req=5

fig3: Preoperative image of neoplastic amputation of left ear (a); the silicone epithesis created using a wax pattern (b); gold bar attached to two titanium implants (c); prosthetic pinna in place, clipped onto the gold bar (d).
Mentions: Our case series comprised 27 patients (24 males and 3 females with a mean age of 33.1 years, range 16–87 years) (Table 1). The etiology was congenital in 17 patients (Figure 1) who were affected by microtia, while eight had posttraumatic mutilation (Figure 2) and two surgical amputation due to neoplasia (Figure 3). Six of the patients with microtia and three of the patients affected by traumatic mutilation had previously undergone plastic reconstructive surgery with rib cartilage grafting and were not satisfied with the results. These patients requested to have their previously reconstructed ear removed and replaced with an epithesis. One patient had previously undergone canaloplasty of the right external auditory meatus. One patient (patient 12) had previously undergone surgery, in a different hospital, using bone-anchored titanium implants but one of the abutments had broken because of a further unlucky trauma.

View Article: PubMed Central - PubMed

ABSTRACT

Different surgical solutions have been proposed for reconstruction of the auricle following loss of the pinna through traumatic injury or neoplastic disease or in patients with congenital defects. Surgical treatment may involve the insertion of an autogenous rib cartilage framework or the use of a porous polymer material inserted into an expanded postauricular flap. Reconstruction with rib cartilage has yielded good results but requires more than one surgical step, and adverse events can occur both at the donor and at the acceptor site; cases of prosthesis rejection have also been described following application of the polymeric prosthesis. The use of a titanium, dowel-retained silicone prosthetic pinna, fixed to the temporal bone, has recently been proposed. This useful surgical approach is indicated particularly after resection of the pinna caused by neoplastic disease or in traumatic auricular injury. Osseointegrated titanium implants used in 27 patients in this study provided them with a safe, reliable, adhesive-free method of anchoring the auricular prostheses. The prostheses allowed recovery of normal physical appearance and all the patients reported that they were completely satisfied with the outcome of the surgical reconstruction. No surgical complications, implant failures, or prosthetic failures were encountered over six months to three years.

No MeSH data available.


Related in: MedlinePlus