Long-Term Follow-Up of Osseointegrated Auricular Reconstruction

Korus, Lisa; Wong, Josh N.; Wilkes, Gordon H.

doi:10.1097/prs.0b013e3181fed595

Cited by 28 publications

(27 citation statements)

References 13 publications

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“…Despite concerns about the psychosocial health of patients with OPAR, published reports have demonstrated very satisfied patients who wear their prosthesis for more than 10 hours per day and consider the prosthesis as a part of them. [11][12][13][14][15] The clinical outcomes of an auricular prosthesis may be evaluated by considering implant success, prosthesis success, and patient satisfaction ( Table 4). The implant success rate in our patient group was 89%.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who were good candidates for autogenous ear reconstruction but elected for OPAR were excluded. Our institution's method of auricular osseointegration has been described previously 11 and consists of 2 stages: placement of 2 or more titanium implants directly into bone (Phase 1) followed by implant exposure 3 to 6 months later for connection of load-bearing abutments (Phase 2). Under ideal circumstances, both phases may be done at 1 sitting.…”

Section: Methodsmentioning

confidence: 99%

“…Overall, patient satisfaction is excellent. 11 The objective of our study was to examine the clinical outcomes of ear reconstruction using osseointegrated auricular prostheses in patients with a compromised ipsilateral TPFF.…”

mentioning

confidence: 99%

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Clinical Outcomes of Osseointegrated Prosthetic Auricular Reconstruction in Patients With a Compromised Ipsilateral Temporoparietal Fascial Flap

Zuo

Wilkes²

2016

Journal of Craniofacial Surgery

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Patients with major ear deformities and associated compromise of the superficial temporal artery are poor candidates for autogenous ear reconstruction because of a tenuous ipsilateral temporoparietal fascial flap (TPFF). Osseointegrated prosthetic auricular reconstruction (OPAR) is an alternative to contralateral free TPFF microsurgical and autogenous reconstruction, but data on clinical outcomes are limited. The records of patients with ear loss or major deformity and a compromised ipsilateral TPFF who underwent OPAR from 1989 to 2013 were reviewed. Satisfaction was assessed using a questionnaire based on a 5 point Likert scale. Thirty-two patients (8 women, 24 men) with mean age 43.0 years (range, 10-70 years) underwent OPAR. The ipsilateral TPFF was compromised due to major trauma (13 patients), cancer extirpation (9), burn injury (4), previous harvest (4), arteriovenous malformation (1), or infection (1). All but 2 patients had an associated craniofacial defect, such as soft tissue deformity (87.5%), hearing loss (46.9%), or bony deformity (31.3%). The overall implant success rate was 88.6% at mean follow-up time of 7.6 years post-OPAR. Prosthesis wear averaged 12.2 hours/day and 6.6 days/week (80.5 hours/week). All 5 patients who experienced implant failures had received prior head and neck irradiation. With their prosthesis, 76.2% (16 patients) stated that their self-consciousness and self-esteem were "better" or "much better," whereas 85.7% (18 patients) stated that their self-image was "better" or "much better." All patients declared that they would undergo the treatment again. Osseointegrated prosthetic auricular reconstruction is a reliable option in this challenging population with high patient satisfaction. Patients with prior radiotherapy may have a higher chance of implant failure and would benefit from extended annual follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Clinical Outcomes of Osseointegrated Prosthetic Auricular Reconstruction in Patients With a Compromised Ipsilateral Temporoparietal Fascial Flap

Zuo

Wilkes²

2016

Journal of Craniofacial Surgery

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“…30 Survival rates of auricular osseointegrated implants are excellent as the overall failure rate of osseointegration in the mastoid region was as low as 2% in some larger studies. 31 Further studies have shown that craniofacial rehabilitation is safe and predictable with high survival rates and low soft tissue reactions with close follow-up. 32 In particular, patients report satisfaction with osseointegrated maxillofacial prostheses.…”

Section: Discussionmentioning

confidence: 98%

Total Auricular Rehabilitation

Littlefield

Tolisano

Sabol

et al. 2015

Journal of Craniofacial Surgery

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“…Wilkes and Wolfaardt [6] list the indications used by their team for prosthetic reconstruction: cancer resection, radiotherapy, absent lower half of the ear, severely compromised tissue, patient preference, failed autogenous reconstruction, potential craniofacial anomaly, poor condition and high operative risk. In contrast, some scholars think the most ideal indication for reconstruction to be an acquired total or subtotal auricular defect, most often traumatic or ablative in origin [7,8]. …”

Section: Introductionmentioning

confidence: 99%

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

Fan²,

Sun³

et al. 2012

ORL

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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.

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Long-Term Follow-Up of Osseointegrated Auricular Reconstruction

Abstract: The authors present long-term results showing both success and complications of the osseointegrated prosthetic ear reconstruction for a variety of different etiologies and age groups.

Cited by 28 publications

References 13 publications

Clinical Outcomes of Osseointegrated Prosthetic Auricular Reconstruction in Patients With a Compromised Ipsilateral Temporoparietal Fascial Flap

Clinical Outcomes of Osseointegrated Prosthetic Auricular Reconstruction in Patients With a Compromised Ipsilateral Temporoparietal Fascial Flap

Total Auricular Rehabilitation

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

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