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Otorinolaringologia 2005 December;55(4):251-6


language: Italian

First and second pharyngeal arch malformations: ear reconstruction with osteointegrated implants

Cervelli V., Grimaldi M., Bottini D., ABrunelli A., Colicchia G., Baldessari E.

Clinica Chirurgica e Ricostruttiva Università degli studi di Roma Tor Vergata, Roma


Aim. First and second pharyngeal arch malformations include the Treacher-Collins syndrome (TCS) and the hemifacial microsomia (HM). These are pathological conditions characterized by alterations to the skeleton framework and to the soft tissues of the face. The anatomical areas of the cephalic district involved in these pathologies can show light malformations, such as ectopia of a well-shaped ear, or serious malformations, such as microtia or anotia. At present, there are 2 different reconstructive surgical techniques involving either the use of autologous materials or the use of osteointegrated titanium screws which are the anchorage for silicon epithesis reproducing, if the case, the contralateral ear. In this paper, the authors report their experience in the reconstruction of the auricle according to the implantation technique.
Methods. Two cases of TCS and 6 cases of HM, mean age 13 years and a total of 10 ears, have been submitted to reconstruction of the auricle using the implantation technique. In 3 cases, 1 of TCS and 2 of HM, the patients were at their second reconstruction attempt with autologous materials with poor results. These patients underwent the surgical application of Branemark’s osteointegrated implants.
Results. This surgical technique showed satisfactory results in all the patients studied.
Conclusion. The conclusion is drawn that osteointegrated implants can be used as a primary reconstructive technique when a certain esthetic result is to be achieved. Surgical osteointegrated implants can, as well, be a valid alternative for a reconstructive approach in cases of reconstructive failure with autologous materials.

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