Lobe of sound: prosthetic rehabilitation of partial auriculectomy defect.

Loss of facial organs in an individual may be due to congenital anomalies or acquired causes. The missing parts of the face like ear, eyes and nose are considered as maxillofacial defects that can be rehabilitated by a prosthesis and/or cosmetic surgeries. This frontier of science has developed into a more reliable and predictable process due to the ever-increasing development of materials and equipments used in this procedure. The fabrication of an ear prosthesis is considered by many prosthetists to be one of the most difficult replacements in maxillofacial reconstruction. The severe undercuts and pronounced convolutions of the ear present a challenge in simulating a naturally proportioned prosthesis. Proper assessment of the disfigured facial organs and a feasible approach to rehabilitating them has for long been the target of clinical maxillofacial prosthodontics. This report describes a simple and engrossing technique to rehabilitate a patient with a partial auricular defect in the most aesthetic and economical manner using medical-grade room temperature vulcanising silicone.

A simplified approach for the rehabilitation of an auricular defect: a case report.

BACKGROUND AND AIM: Replacement of missing ear is a challenging task in which extensive array of materials and techniques have been employed. Materials such as silicones and methacrylate acrylic resins have been widely used for auricular prosthesis. This article describes a simplified procedure for fabricating resilient heat-cured acrylic resin auricular prosthesis, retained with a custom-made acrylic bar with ball attachments. CASE DESCRIPTION AND METHODS: A male patient was reported with right ear loss. A modified technique was preferred to fabricate ear prosthesis with resilient heat-cured acrylic resin in which heat-cured acrylic retentive bar was incorporated. FINDINGS AND OUTCOMES: Contrary to silicones, resilient heat-cured acrylic resin was more economical and compatible with acrylic retentive bar and resulted in a more long-lasting auricular prosthesis. CONCLUSION: Resilient heat-cured acrylic resin was proven to be a better alternative in terms of strength and durability. CLINICAL RELEVANCE: This article presents an economical and simplified approach for the fabrication of prosthesis for a missing ear.

Anaplastology: changing appearances/changing lives.

This is a synopsis of the presentation delivered at the Society of Otorhinolaryngology and Head-Neck Nurses' Annual Congress and Nursing Symposium, September 11, 2012 in Washington, DC. We all have imperfections in our faces and bodies that we would like to change. Consider, though, the cancer patient or the trauma victim who must deal with a facial disfigurement that completely changes their appearance, and often, their ability to function normally. Anaplastology, which combines art and science through creativity and functionality, can make monumental improvements in the quality of a person's life by giving acceptable appearance back to the patient. Custom-made appliances and prosthetic creations can bring hope and confidence back to the patient. Individualized adaptations can make the prosthetic a true work of art. Nurses work closely with patients who are benefitting from this creative process. Arriving at a successful and pleasing outcome is extremely satisfying for the entire team, the patient and family.

Bone-anchored titanium implants for auricular rehabilitation: case report and review of literature.

CONTEXT AND OBJECTIVE: Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. TYPE OF STUDY: Case report, Universidade Federal de São Paulo (UNIFESP). METHODS: A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. RESULTS: The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. CONCLUSION: The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavity.

Bone-anchored titanium implants for auricular rehabilitation: case report and review of literature / Implantes osseointegrados de titânio para reabilitação auricular: relato de caso e revisão da literatura

CONTEXT AND OBJECTIVE: Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. TYPE OF STUDY: Case report, Universidade Federal de São Paulo (UNIFESP). METHODS: A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. RESULTS: The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. CONCLUSION: The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavity

CONTEXTO E OBJETIVO: Os implantes osseointegrados adquiriram papel importante na reabilitação protética de pacientes com defeitos craniofaciais. As principais indicações são ausência local de tecidos para reconstrução autógena, falha anterior de reconstrução e opção do paciente. Este artigo apresenta um caso clínico e discute as indicações e vantagens da técnica de implantes osseointegrados para a retenção de próteses auriculares. TIPO DE ESTUDO E LOCAL: Relato de caso clínico, Universidade Federal de São Paulo (UNIFESP). MÉTODOS: Paciente do sexo feminino recebeu três implantes na região auricular após ressecção cirúrgica de hemangioma na orelha esquerda. O tempo de osseointegração no osso temporal foi de três meses. Após a confecção de prótese auricular implanto-suportada, a paciente foi observada por 12 meses. RESULTADOS: Os parâmetros clínicos analisados mostraram boa cicatrização pós-operatória, saúde dos tecidos adjacentes ao implante, boa higiene e nenhuma perda de implantes. A boa higiene combinada a pouca espessura e imobilidade dos tecidos moles perimplantares resulta em poucas complicações. A integração dos implantes craniofaciais parece variar conforme o local, e a idade avançada afeta a osseointegração no osso temporal. A frequência de reações adversas cutâneas nos tecidos perimplantares é geralmente baixa. CONCLUSÃO: A técnica cirúrgica para a reabilitação com próteses auriculares implanto-suportadas parece ser simples e está associada a baixos índices de reações cutâneas adversas e complicações no longo prazo. As próteses ancoradas por implantes osseointegrados parecem proporcionar melhor retenção do que as próteses suportadas nas armações de óculos, menor possibilidade de descoloração pelo uso de adesivos e melhores resultados estéticos do que as próteses ancoradas na cavidade cirúrgica.

Auricular episthesis retained by an attachment system (2 case reports).

The use of osseointegration for bone anchorage in the prosthetic management of craniofacial defects has been successfully applied for many years. Different methods can be used for reconstruction of the aural atresia. Nowadays plastic surgery for auricular reconstruction and the bone-anchored episthesis are used for correction of aural atresia. There have been several studies in the literature comparng these techniques. According to those studies, bone-anchored episthesis is an excellent alternative to plastic reconstructive surgery of the auricle. In the present study we present 2 cases with different etiologic factors. The patients' right external ears were absent. There was loss in hearing function in one of the patients. We applied external ear episthesis with a bone-anchored system.

Facial defects restored with extraoral implant-supported prostheses.

A facial defect results in cosmetic, functional, and psychologic problems and acts as a difficult and challenging procedure for the maxillofacial surgeon and the prosthodontist. Retention of a facial prosthesis is an important key in the patient's satisfaction and acceptance. The introduction of extraoral implant applications have been accepted as an advanced retention method. The purpose of this article is to report the results from our clinical experience with patients wearing facial prostheses anchored to extraoral ITI implants (Straumann, AG, Basel, Switzerland).

[A new implant system in head and neck surgery]. / Ein neues Implantatsystem in der Kopf-Hals-Chirurgie.

Defects in the head and neck region following extensive tumor removal are sometimes difficult to reconstruct by local or free flaps. An epithesis is a recommended alternative in defects of the ear, the nose or the orbital region. Nevertheless problems may arise in the appropriate fixation of the epithesis. With the intermobile-cylinder-implant-system (IMZ), the epithesis is firmly fixed by means of osseointegration of the implants and an abutment in the area of the defect. The various steps of the operation and clinical applications are presented.

Silicone ectoprostheses for correction of facial defects.

Twenty-two patients with congenital and acquired defects, rehabilitated with silicone ectoprostheses, were followed up for 6 mo to 4 yr. The simplicity of the procedure, its good results and the early physical and social rehabilitation attained, favor its use when adequately indicated.