RESUMO
Extensive defects of the ear require satisfactory cosmetic reconstruction to enable the patient to achieve full social integration. Although surgical procedures are the gold standard for reconstruction of the ear, in some cases they cannot be performed because of extended scars, threatening tumor, or congenital tissue abnormalities. Prosthetic reconstruction of the auricle is an established and reliable alternative technique to autologous surgical reconstructions. Since studies performed by Brånemark, osseointegrated implants have been widely used to provide a reliable and stable anchorage for a prosthesis (prosthesis anchored to bone). To allow good osseointegration of the titanium screw implants, two stages are necessary. After careful preparation for the surgical procedure (local and general examination, computed tomography scan, skin preparation), screws are implanted into bone, which are then covered by a skin flap. During the second stage, the skin is incised, and penetrating fixtures are attached to the screw implants, which allow fixation of the prosthesis. This procedure is reliable and reproducible, with good to excellent results and stability over time.
RESUMO
The authors present a case of a patient with a large occipital meningioma, treated by embolisation and surgery, in which skin necrosis occurred overlying the craniotomy bone flap. A free Latissimus dorsi flap was used to cover the tissue loss but poor healing and flap condition occurred due to contact with the anti-sore bed system making it impossible to maintain the patient on dorsal position. A cephalic suspension was carried out by Tessier's diadem making it possible to salvage the flap and to treat the patient.
