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An implant-retained auricular prosthesis complicated by a modified temporal bone resection.

Paul Canallatos1, Jay Jayanetti2, John Beumer3

  • 1Fellow, Maxillofacial Prosthetics Fellowship, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif; Maxillofacial Prosthodontist, Department of Oral Oncology and Maxillofacial Prosthetics, Erie County Medical Center, Buffalo, NY.

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Summary

This case report details the successful fabrication of an implant-retained auricular prosthesis for a patient with a sebaceous carcinoma. The prosthesis addressed challenges posed by implants placed in suboptimal positions after temporal bone resection.

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Area of Science:

  • Otolaryngology
  • Plastic Surgery
  • Biomedical Engineering

Background:

  • Sebaceous carcinoma of the auricle can necessitate extensive surgical resection, including temporal bone resection and auriculectomy.
  • Tumor extension into the temporal bone may compromise ideal osseous sites for craniofacial implant placement.
  • Suboptimal implant positioning presents unique challenges for prosthetic rehabilitation.

Purpose of the Study:

  • To describe the fabrication of an implant-retained auricular prosthesis.
  • To address challenges associated with implants in suboptimal positions following oncologic resection.
  • To detail prosthetic management for patients with complex auricular defects.

Main Methods:

  • Modified temporal bone resection and total auriculectomy for sebaceous carcinoma removal.
  • Delayed placement of craniofacial implants into residual temporal bone in superior and posterior positions.
  • Fabrication of an implant-retained auricular prosthesis designed for suboptimal implant emergence through hair-bearing skin.

Main Results:

  • Successful fabrication and fitting of an implant-retained auricular prosthesis.
  • Optimization of prosthesis stability, retention, and esthetics despite challenging implant locations.
  • Management of prosthetic space, hygiene access, and peri-implant tissue health in hair-bearing areas.

Conclusions:

  • Implant-retained auricular prostheses can be successfully fabricated even with implants in suboptimal positions.
  • Careful prosthetic design and management are crucial for optimizing function, esthetics, and tissue health.
  • This approach offers a viable reconstructive option for patients with complex auricular defects after cancer surgery.