Auricular prostheses attached to osseointegrated implants: multidisciplinary work-up and clinical evaluation

Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1017-1027. doi: 10.1007/s00405-019-05311-0. Epub 2019 Feb 5.

Abstract

Purpose: Not long after the introduction of osseointegrated implants outside the oral cavity, auricular prostheses are retrained on osseointegrated implants. New insights have been gained with the next-generation percutaneous osseointegrated titanium implants for bone conduction hearing since its introduction in 2010. As a result, the same technology was introduced in the Vistafix® system (VXI implant) to retain auricular prostheses. The aim of this study is to evaluate the surgical procedure, clinical outcome, and satisfaction of the patient of osseointegration-retained auricular prosthesis using VXI implants.

Materials and methods: 11 patients who received an auricular prosthesis using VXI implants between December 2012 and November 2017 were evaluated retrospectively. The patient's medical files were reviewed to assess clinical complications and the necessity for revision surgery. The subjective outcome was measured using the Glasgow benefit inventory (GBI).

Results: In total, 31 implants were placed in 11 patients. None of these implants were lost nor revision surgery needed. An adverse skin reaction was observed in 13.0% of the implants and in 27.2% of the patients, adequately treated with an antibiotic ointment. The average follow-up time was 2 years and 7 months. The GBI displayed a positive score in every patient.

Conclusions: The VXI implants used are a safe and reliable treatment option for retaining auricular prostheses in patients with an absent auricle. Patients were satisfied with their auricular prosthesis and showed benefit in quality of life. Studies with larger numbers and preferably a prospective character are needed to draw statistically significant conclusions.

Keywords: Auricle; Hearing loss; Implants; Microtia; Prosthesis; Skin reactions.

MeSH terms

  • Adult
  • Aged
  • Bone Conduction
  • Bone-Anchored Prosthesis
  • Congenital Microtia / epidemiology
  • Congenital Microtia / surgery*
  • Ear Auricle* / pathology
  • Ear Auricle* / surgery
  • Ear Deformities, Acquired / epidemiology
  • Ear Deformities, Acquired / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Osseointegration*
  • Outcome and Process Assessment, Health Care
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Postoperative Complications* / therapy
  • Prospective Studies
  • Prostheses and Implants*
  • Prosthesis Design
  • Prosthesis Implantation* / adverse effects
  • Prosthesis Implantation* / instrumentation
  • Prosthesis Implantation* / methods
  • Quality of Life*
  • Reoperation / methods
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Titanium

Substances

  • Titanium