Image-Guided Surgical Navigation in Implant-Based Auricular Reconstruction

Introduction

In principle, the auricle can be reconstructed surgically using free skin grafts in combination with locoregional flaps. Reconstruction of the supporting tissues in the auricle requires the transplantation of cartilage. These surgical procedures are technically demanding and are carried out in several steps. A failed autologous reconstruction is one of the major indications for implant-retained prostheses. The scarring associated with previous surgery makes further attempts at autogenous reconstruction difficult, thus making prosthetic reconstruction a reasonable option. In addition, patients with acquired total or subtotal auricular defects (due to trauma or tumor surgery) and hemifacial microsomia exhibit varying degrees of skeletal hypoplasia, which may make surgical reconstruction very complex, are ideal candidates for prosthetic rehabilitation. In cases where surgical reconstruction is not an option, placement of osseo-integrated implants for an auricular prosthesis can be done in 1 or 2 stages in a relatively short period of time. Long-term follow-up shows a low rate of perioperative and long-term complications and patients expressed a high degree of satisfaction with the aesthetic results. With auricular prostheses that are fixed to implants, many of their limitations have been overcome: spectacles can be removed and patients can participate in sports activities without exposing the defect.