The use of osseointegrated epistheses in severe face burn sequelae

Four cases are presented of severe face burn sequelae with mutilation of one or both pinnae, treated using osseointegrated epistheses. In the light of over 10 years' use of this technique, applied in other forms of anatomical deficits in the head such as congenital malformations, demolition owing to extensive neoplasias, and serious traumatic sequelae, it is recommended that burn patients should be carefully considered from both the psychological and the technical point of view. It is suggested that such patients should be analysed by a specific team consisting of a plastic surgeon, a psychologist, and a prosthetist who assess their expectations, analyse their actual reactions, and above all judge their degree of acceptance of an episthesis. A description is provided of the advantages of the technique, which is mainly indicated when the mutilated area presents a deficit of tissues capable of being reconstructed using traditional surgical techniques.