Comparative Assessment of Effectiveness of Various Fixation Methods for Auricular Prostheses.

backgroundThe absence of an intact auricle can lead to both functional impairments and psychological distress, prompting individuals to withdraw from social interactions. Consequently, there is a pressing need for functional and aesthetic rehabilitation in these patients to restore their psychosocial well-being. When surgical reconstruction is not optimal, an auricular prosthesis can be fabricated and fixed with glue to the skin or with a magnetic fixation on osteointegrated implants.

objectivesThis comparative study aims to evaluate the efficacy of auricle defect restoration using prostheses with adhesive fixation to the skin and magnetic fixation on implants inserted into the mastoid processes.

methodsFourteen patients (eight men and six women, average age 42 years) were included in the study. Among them, 12 patients had unilateral auricle defects, while two patients presented bilateral defects. The causes of auricle defects were predominantly traumatic (12 cases), with two cases attributed to congenital factors. Patients were stratified into two groups: Group 1, comprised six patients, in whom the auricular prosthesis was fixated to the skin using a biological adhesive (glue) and Group 2 consisted of eight patients, in whom the auricular prosthesis was retention osseointegrated implants inserted into the mastoid processes of the temporal bone. In Group 2, five cases were rehabilitated with prostheses featuring magnetic fixation, while the remaining three cases utilized prostheses with attachment fixation.

resultsDuring the observation period ranging from six months to three years, none of the patients in group 2 encountered implant-related issues such as poor osseointegration or wound healing complications. Overall, all patients expressed satisfaction with the treatment outcomes, citing the relatively short hospital stay and less invasive nature of the procedure compared to alternative treatments.

conclusionImplant-retained auricular prostheses present a favorable treatment option characterized by excellent retention and high patient satisfaction. In contrast, prostheses fixed with adhesives pose several drawbacks, including skin irritation, dermatitis, and the potential for deformation of the auricular prostheses, presenting significant challenges for both patients and clinicians. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .