FABRICATION OF SILICONE AURICULAR PROSTHESIS RETAINED BY CUSTOMISED SMOOTH SURFACE TITANIUM IMPLANT IN BURN PATIENT

Pinna loss is not uncommon due to accident, burn, or defect resulting from congenital malformation. Auricular prosthesis are generally fabricated by PMMA or silicones and usually retained by spectacle, hairband, adhesives etc. Loss of soft tissue and thinning of superficial skin due to burn creates a lot of problems related to retention of conventional auricular prosthesis especially in temperate zones. Cortical bone thickness in mastoid area remains a hope for placement of titanium implants in these patients. Conventional two piece implants have a major drawback that is causes recurrent peri-implant skin infection in burn patient which may lead to constant irritation or implant failure. It is because of two major reasons one being the transition zone between implant body and abutment and other is surface roughness of implants. To avoid this in present case customised single piece smooth surface wide neck implants were used so that thin skin after burn do not get soggy and inflamed to compromise the prognosis. The external auditory meatus (EAM) always serves as a reference to locate clear acrylic stent. Diagnostic procedure done to confirm locations of implants using high resolution computed tomographic scan of temporal bone with radiographic auricular stent. Fabrication of silicone auricular prosthesis using cast bar and clip system as retentive aid has been described.