Auricular Prosthesis Research Articles

Comparison of two impression techniques for auricular prosthesis: Pilot study

The purpose of this article was to compare the accuracy of a new impression technique, the triple-layer impression technique (TLIT), with the conventional impression technique (CIT) to fabricate an auricular prosthesis. Fifteen male subjects (aged 22-45 yr) were selected. Ten markings were made on the subject's ear (super aurale [sa], sub aurale [sba], pre aurale [pra], post aurale [poa], A, A1, B, B1, C, and C1) and five measurements (sa-sba, pra-poa, A-A1, B-B1, and C-C1) were made. Custom-made trays were used to record impression in CIT and TLIT. Impressions were made using alginate, and models were cast with type IV gypsum product. Markings were transferred on the cast. Measurements were rechecked on the models. Distribution analysis of difference in measurements between the two impression techniques and the subject's actual values was evaluated. Sign test was used to analyze the statistical significance. Statistically significant differences were found in measurements A-A1, B-B1, and C-C1 between the two techniques when compared with the subject's actual dimensions (p < 0.01). TLIT was found to produce accurate models when compared with CIT. The TLIT used in the study was cost effective, less technique sensitive, and tailor made to reduce chairside orientation time during wax try-in appointments for rehabilitating patients, especially those with unilateral auricular defects.

Fabrication of Mirror Image Prosthetic Ears-A Short Review

Maxillofacial prosthodontics gains utmost significance as the process not only tries to develop acceptable esthetics but also tries to enhance the psychological comfort of the patient by restoring the defective or missing craniofacial structures. This science has developed into a more reliable and predictable process due to ever increasing development of materials and equipments used in such procedures, but no single procedure stands out as the most effective method in all the situations. The present article tries to give an overview of different methods used to fabricate auricular prosthesis so as to give an array options available to arrive at the best possible outcome.

Construction of an Implant‐Retained Auricular Prosthesis with the Aid of Contemporary Digital Technologies: A Clinical Report

Implant-retained auricular prostheses are a successful treatment modality for children with microtia. They involve only minor surgical intervention of implant placement and result in an esthetically pleasing outcome. Integration of digital technologies (DT) in the prosthetic reconstruction process is a new approach toward enhancing outcomes. In this report we present a case of auricular prosthetic reconstruction following two implant placements in the right mastoid region. The ear prosthesis was constructed with the aid of various DTs. A structured light laser scanner was used to digitize the nondefect patient ear. The digitized 3D ear was then manipulated in specialist software, mirrored to reflect the opposing side, and a Rapid Prototyping (RP) machine (Z-Corp) was used to manufacture the soft tissue required. This RP-mirrored ear model allows very accurate reproduction to replicate missing soft tissue. A color Spectrometer was used to accurately reproduce skin tones. The use of these technologies is now routine practice at our unit. They enhance prosthetic outcomes and esthetics, save the prosthetist's time, and are digitally stored and subsequently readily available and reproducible.

Implant-Supported Auricular Prosthesis - An Overview.

Auricular defects can result from tumor resection, congenital malformations, and trauma. These defects lack hard or soft tissue undercuts, and prosthesis retention is obtained primarily by the use of skin adhesives. There are significant disadvantages to the use of skin adhesives.The margins of the facial prosthesis may be damaged by repeated application and removal of the adhesive, and occasionally a patient will have a toxic skin reaction. The retentive capacity of adhesives may be insufficient in mobile tissues or in moist environments. The presence of hair also complicates the use of skin adhesives. The use of craniofacial titanium implants for restoring auricular defects may provide many benefits. The quality of retention provided far exceeds that obtained with adhesives, and skin-penetrating osseointegrated implants have demonstrated an excellent level of predictability when placed in bone in the auricular area.The aim of this paper is to present concept and principles of maxillofacial implants, history, literature review , advantages and disadvantages, considerations in treatment planning, finally the treatment phases of an implant-supported auricular prosthesis in particular and prospective developments for ear prosthesis.

A Simplified Technique for Orientation of a Bone Anchored Auricular Prostheses: a Clinical Report

ABSTRACTBackgroundA simple technique was presented in this clinical report for orientation of a bone anchored auricular prosthesis.MethodsThe proposed technique includes drawing the intact ear on a transparent celluloid paper or radiographic film and flipping it to the opposite side and relating it to the fixed anatomical features on the face of patient.ResultsThe drawing, by this way provides a simple and easy way to duplicate and transfer the exact size and position of the intact ear to the defect side.ConclusionsThis technique provides a simple, safe, inexpensive and time saving yet, an accurate and effective surgical template that orients the craniofacial implants to the confines of the definitive auricular prosthesis. It is indicated for restoration of single missing external ear either in aplasia, injuries and total resection.

Osseointegration Technique in Patients with Acquired Auricular Deformities and Failed Previous Reconstruction: A Retrospective Study of Long-Term Follow-Up and Chinese Experience

Objectives: To evaluate the complication rate and patient satisfaction of reconstruction of acquired auricular deformities and failed previous reconstruction by the osseointegration technique. Methods: The study enrolled 24 patients from January 2002 to December 2005. Data collected included demographic information, success rate of auricular prostheses, site of implants, survival rate of implants, occurrence of skin reaction and condition of the prosthetic ear. Results: Twenty-five ears (24 patients) were implanted. All ears were healing well with a lifelike appearance, stable fixation and natural color; except for 2 instances of implants dislocated by trauma, the rest survived well by first intention; skin reaction was the most troublesome complication, no patient was able to maintain a consistent level of soft-tissue health for the whole follow-up period, but the ratio and degree of skin reaction decreased gradually. The time of wearing prosthetic ears was more than 8 h/day. The average time length until prosthetic ear replacement was 3.5 years. There were no intracranial or systemic complications. Conclusion: The osseointegration technique can be the method of choice for acquired auricular defects and failed reconstructions. Follow-up management is important to the health of the implants and the surrounding soft tissue and to preserve the prosthesis and its retention mechanism.

Bilateral Implant‐Retained Auricular Prosthesis for a Patient with Congenitally Missing Ears. A Clinical Report

Microtia is a major congenital anomaly of the external ear. It includes a spectrum of deformities from a grossly normal but small ear to the absence of the entire external ear. These deformities account for three in every 10,000 births, with bilaterally missing ears seen in fewer than 10% of all cases. Congenital abnormalities of the ear are unlikely to result in the complete absence of the ears, but the patient presented in this article had bilateral congenitally missing ears. There was loss of anatomic landmarks and alteration of normal bony architecture. Minimal tissue was available for retention; therefore, conventional techniques could not be used for achieving retention. A two-implant-supported auricular prosthesis was planned, but the patient was found to have deficient bone in the implant site. Hence the implants were placed posterior to these sites, and the superstructure was modified to accommodate for this change in position of the implant to ensure the esthetic positioning of the prosthesis.

Planning implant positions for an auricular prosthesis with digital data

The esthetic result of an auricular prosthesis is influenced by the position of the prosthesis incorporating the implants. The entire surface of the patient's head is captured by means of a conventional computed tomography (CT). The digital data are used to mirror the contralateral unimpaired ear for restoration of the impaired side. The virtual ear is integrated into a template covering the auricular defect and indexed to the nasal area with computer-aided technology (CAD/CAM). This virtual template is converted into an acrylic resin template. With that the surgeon and the anaplastologist should determine the optimal implant position of the auricular prosthesis.

Prosthodontic rehabilitation of hemifacial microsomia

Hemifacial microsomia, a developmental anomaly involving the first and second branchial arches, is one of the most common craniofacial anomalies. This disorder affects orofacial structures with varying clinical features. It is also associated with underdevelopment of the temporomandibular joint, mandibular ramus, masticatory muscles, ears, and occasionally defects in facial nerve and muscles. Physical deformities affecting face, ears, eyes, and oral cavity can pose esthetic and functional problems. The rehabilitation of these patients should be multidisciplinary including prosthodontic management as these patients present with complex clinical features. Treatment approach depends on patient's age, extent of physical and psychological deformity. The fabrication of auricular prosthesis is considered to be one of the most difficult replacements in maxillofacial rehabilitation. The severe undercuts and pronounced convolutions of the ear's surface present a challenge in simulating a natural proportioned prosthesis. This paper presents an outline in basic fabrication of prosthetic ear by conventional technique where the wax pattern is fabricated from the impression of an individual with a similarly proportioned ear.

Manufacturing Implant Supported Auricular Prostheses by Rapid Prototyping Techniques

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses.

Craniofacial Implant-Retained Auricular Prosthesis: A Case Report

Implants provide patients with a safe and reliable method for anchoring auricular prostheses that enable restoration of their normal appearance and offer improved quality of life. In this case report, an auricular prosthesis was fabricated for a patient who had lost his right external ear in a traffic accident. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to the implant were used.

Reconstrucción auricular con implantes osteointegrados en un solo tiempo en pacientes seleccionados

Our goal is to demonstrate that the use of osseointegrated materials allows us to achieve a proper fixation of auricular prosthesis with a minimum degree of ...

Fabrication of an auricular prosthesis: a case report

The fabrication of ear prosthesis is considered by many prosthetists to be one of the more difficult replacements in maxillofacial reconstruction. The severe undercuts and pronounced convolutions of the ear's surface present a challenge in simulating a natural proportioned prosthesis. The mould for the ear is generally made by creating a three surface die to reproduce the unique configuration adequately and to allow retrieval of the finished prosthesis without damage. This article presents an outlined procedure in the basic fabrication of a prosthetic ear by a conventional technique where the wax pattern is fabricated from the impression of an individual with a similarly proportioned ear. Fabricating an auricular prosthesis may be part of the work of a maxillofacial department.

The Potential of Cohesive Silicone for Facial Prosthetic Use: A Material Property Study and a Clinical Report

Prosthetic reconstruction of a facial defect can help to reduce disfigurement and restore the social functioning of the patient. Several methods for holding a prosthesis in place exist, including the use of osseointegrated implants and medical adhesive agents; however, since the treatment options for some patients may be restricted by various health conditions and other limitations, including allergies to adhesive agents, a history of radiation therapy, and financial issues, other options that suit individual demands are required. The objectives of this study were to test the hypothesis that adhesive characteristics could be bestowed on silicone elastomers by altering their catalyst/base silicone ratios (CBR) and to examine the effect of the thickness of the cohesive silicone layer of a prosthesis on its initial adhesive strength. The adhesive strengths of specimens with CBRs ranking from 1/10 to 1/70 were examined by the rolling ball tack test. A tensile test was used to evaluate the tensile adhesive strengths of specimens made of layers of cohesive silicone (CBR 1/60) and normal silicone (CBR 1/10) with different thicknesses. Auricular prostheses containing cohesive silicone on the skin side were applied to a 50-year-old man with defects in both auricular regions and with reduced manual dexterity due to serious burns. The rolling distance was reduced with a decrease in CBR, and a thinner cohesive silicone (CBR 1/60) layer demonstrated a higher peak load. On clinical application, the adhesion of the auricular prosthesis containing cohesive silicone was improved by expanding the adhesive area and altering the thickness of the cohesive silicone layer, resulting in sufficient adhesion and easier handling than that achieved using an adhesive agent 1 year post delivery. These results suggest that cohesive silicone can be used as a glueless retentive material for facial prostheses.

An Enveloped Auricular Prosthesis for Ear Defect: A Clinical Report

An Enveloped Auricular Prosthesis for Ear Defect: A Clinical Report

Designing and manufacturing an auricular prosthesis using computed tomography, 3-dimensional photographic imaging, and additive manufacturing: A clinical report

The method of fabricating an auricular prosthesis by digitally positioning a mirror image of the soft tissue, then designing and using rapid prototyping to produce the mold, can reduce the steps and time needed to create a prosthesis by the traditional approach of sculpting either wax or clay. The purpose of this clinical report is to illustrate how the use of 3-dimensional (3-D) photography, computer technology, and additive manufacturing can extensively reduce many of the preliminary procedures currently used to create an auricular prosthesis.

Maxillofacial Prosthetic Management of an Auricular Defect for a Young Patient With Hemifacial Microsomia: A Clinical Report

Facial anomalies in hemifacial microsomia patients may have significant psychosocial impact even from a very young age. The management and fabrication of an auricular prosthesis replacement supported by endosseous craniofacial implants for a young patient with Goldenhar-Gorlin Syndrome has been reported. It is beneficial for the defects of a hemifacial microsomia patient to be managed as early as possible, consistent with the patient's ability to manage the prosthesis.

Prosthodontic rehabilitation of a patient with bilateral auricular deformity

Maxillofacial prosthodontics is an art and science which provides life like appearance to the person with facial deformity. Maxillofacial prosthetic rehabilitation for acquired defects has become more complex and sophisticated with advancement in techniques and materials. This case report describes the clinical and laboratory procedure for fabricating an auricular prosthesis for a patient with trauma related bilateral auricular deformity. Ear prosthesis was fabricated in two parts taking retention from external auditory canal.

Cochlear implantation after burn injury of the head.

The loss of an auricle as a side-effect of burn injuries is a rare clinical event. If the patient also suffers fromsensorineural deafness, it is necessary, in planning management, to consider the aesthetic effects ofreconstructing or replacing the auricle as well as restoring the hearing. In this case report of a 17-year-oldboy who suffered a third-degree burn injury to his head we describe the surgical approach for cochlearimplantation combined with placement of a bone-anchored auricular prosthesis. Hearing restoration forone ear was successfully combined with an adequate aesthetic rehabilitation of both external ears.

Implant-Retained Auricular Prosthesis

Auricular defects may result from congenital malformations, injuries from motor vehicle crashes, trauma, or tumor resections. An auricular prosthesis was fabricated for a patient who had an injury from a motor vehicle crash. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to implant were used. This prosthesis was acceptable to the patient because of excellent support, retentive abilities, and the patient's appearance.