Auricular prostheses

An auricular prosthesis is an artificial substitute for the auricle; the term epithesis is used synonymously. A myriad of materials have been used in the long history of anaplastology. However, the breakthrough came with the introduction of modern silicones and their colorings. While there are still indications for noninvasive methods of retention, such as medical adhesives, the best and most reliable method of fixation is bone anchorage. Long-lasting osseointegration with reaction-free skin penetration can be achieved with titanium implants. The first system used extraorally was the Brånemark flange fixture. Later, different solitary titanium implants were introduced, such as the ITI system. A different strategy used the titanium grids (Epitec) or plates (Epiplating) derived from osteosynthesis systems. These systems are fixed subperiostally with several bone screws, and are therefore also labeled as grouped implants. With these modern developments, secure retention can also be achieved in unfavorable anatomical situations. Advantages of implant-retained auricular prostheses include: optimal camouflage, predictable cosmetic results, fast rehabilitation, no donor site morbidity and early detection of tumor recurrence. Depending on the clinical setting, prosthetic rehabilitation can be a viable treatment option, and more than just an alternative to plastic reconstructive surgery.