Long-term follow-up of osseointegrated auricular reconstruction

• Published in: Plastic and reconstructive surgery (1963) Vol. 127; no. 2; p. 630
• Main Authors: Korus, Lisa J, Wong, Josh N, Wilkes, Gordon H
• Format: Journal Article
• Language: English
• Published: United States 01.02.2011
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Congenital Abnormalities - surgery; Congenital Microtia; Ear - abnormalities; Ear - surgery; Ear Auricle - injuries; Ear Auricle - pathology; Ear Auricle - surgery; Female; Follow-Up Studies; Humans; Logistic Models; Male; Middle Aged; Necrosis; Osseointegration; Patient Satisfaction; Prostheses and Implants; Young Adult
• ISSN: 1529-4242
• DOI: 10.1097/PRS.0b013e3181fed595

Auricular deformity presents a formidable challenge for the reconstructive surgeon, and osseointegrated auricular reconstruction provides a safe and reliable option. The authors sought to review long-term results of osseointegrated auricular reconstruction at the Institute for Reconstructive Sciences in Medicine. A chart review examining demographics, skin reactions (defined by a modified Holgers classification), and complications at the Institute for Reconstructive Sciences in Medicine was completed. A multivariate binary linear logistic regression analysis was performed to determine whether there was a correlation between the likelihood of a skin reaction and certain patient demographics. A survey was then developed to assess patient satisfaction. Seventy-five osseointegrated auricular reconstructions were performed on 69 patients at the Institute for Reconstructive Sciences in Medicine from 1989 to 2007; mean patient age was 39 years (range, 9 to 76 years). The most common indication for reconstruction was posttraumatic, then congenital and oncologic. The frequency of Holgers reactions was as follows: no reaction, 69 percent; red tissue, 15 percent; excessive tissue, 10 percent; red and moist tissue, 3 percent; granulation tissue, 2 percent; and soft-tissue necrosis, 1 percent. Multivariate binary linear logistic regression analysis found that smoking, younger age, and female gender were associated with the occurrence of a reaction. The overall failure rate of osseointegration in the mastoid region was 2 percent. Survey results found generally satisfied patients willing to undergo the same procedure again, although 55 percent felt that they had had a skin reaction. The authors present long-term results showing both success and complications of the osseointegrated prosthetic ear reconstruction for a variety of different etiologies and age groups.