Pruthi Gunjan, Bansal Kirti, Jain Veena, Kumar Koli Dheeraj
CDER, AIIMS, New Delhi, India.
J Oral Biol Craniofac Res. 2020 Jul-Sep;10(3):266-275. doi: 10.1016/j.jobcr.2020.04.009. Epub 2020 May 4.
To discuss the indications, technical steps for fabrication of implant retained auricular prosthesis (IRAP), and treatment outcome at various follow up visits.
We performed retrospective data collection of all consecutively treated patients referred to us for auricular reconstruction from 2006 till 2018. Each case was analysed for: feasibility of autogenous reconstruction vs IRAP, surgical procedure, type of anaesthesia, type of implants, soft tissue response, implant success and survival rate, prosthetic attachment, aesthetic outcome, complications and patient acceptance. Procedure for fabrication of IRAP has also been written in detail to benefit readers.
IRAP was considered feasible and performed in eight out of 27 patients referred for auricular reconstruction. 20 implants were placed and total 10 prostheses were fabricated. Implant success rate and survival rate was 90% and 100% respectively till last follow-up of each patient. Bar and clip attachments were used in 60% and stud attachments in 40% of prostheses. After stage II surgery, grade I soft tissue inflammation was reported around two implants (10%), and grade III around one implant (5%). Implant with grade III inflammation showed features of recurrent infection and thus was left buried under soft tissues. These prostheses were aesthetically pleasing in all cases in the early post-operative period.
A systematic, step wise procedure with multi-disciplinary approach is a key to success for the fabrication of implant retained auricular prosthesis.
探讨植入式保留耳廓假体(IRAP)的适应证、制作技术步骤以及不同随访期的治疗效果。
我们对2006年至2018年期间转诊至我院进行耳廓重建的所有连续治疗患者进行了回顾性数据收集。对每个病例分析以下内容:自体重建与IRAP的可行性、手术过程、麻醉类型、植入物类型、软组织反应、植入物成功率和存活率、假体附着情况、美学效果、并发症及患者接受度。还详细撰写了IRAP的制作流程,以飨读者。
在转诊进行耳廓重建的27例患者中,8例患者被认为可行并接受了IRAP治疗。共植入20枚植入物,制作了10个假体。截至每位患者的最后一次随访,植入物成功率和存活率分别为90%和100%。60%的假体采用杆夹式附着,40%采用螺柱式附着。二期手术后,2枚植入物(10%)周围出现I级软组织炎症,1枚植入物(5%)周围出现III级炎症。出现III级炎症的植入物表现出反复感染的特征,因此被留在软组织下。在所有病例的术后早期,这些假体的美学效果均令人满意。
系统、分步的多学科方法是成功制作植入式保留耳廓假体的关键。