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The fabrication of ear prosthesis is considered by many prosthetists to be one of the more difficult replacements in maxillofacial reconstruction. The severe undercuts and pronounced convolutions of the ear's surface present a challenge in simulating a natural proportioned prosthesis. The mould for the ear is generally made by creating a three surface die to reproduce the unique configuration adequately and to allow retrieval of the finished prosthesis without damage. This article presents an outlined procedure in the basic fabrication of a prosthetic ear by a conventional technique where the wax pattern is fabricated from the impression of an individual with a similarly proportioned ear.
Clinical Relevance: Fabricating an auricular prosthesis may be part of the work of a maxillofacial department.
Article
Absence of all or part of the external ear may be either acquired (surgical resection or trauma) or congenital (microtia with hemifacial microsomia). To make an informed choice between autogenous surgical reconstruction and wearing a prosthetic ear retained by implants or skin contact adhesives, the patient should receive guidance and advice from an expert team committed to optimal care.1–9
At present, a satisfactory solution may be achieved with the fabrication of a prosthetic ear that copies the normal contralateral ear. With congenital defects, such as microtia, where often one ear is missing, existing facial asymmetry presents difficulty in determinig the size and location of an artificial ear that will maintain facial harmony. However, the success of the prosthesis depends upon the maxillofacial technician's artistry and ability to copy the normal contralateral ear. This is achieved using anthropometric measurements and visual assessment.10–12 An artificial auricular/ear prosthesis restores a portion of, or the entire, outer ear. The artificial ear or auricular prosthesis provides a form of rehabilitation when surgical reconstruction is not viable or not preferred by the patient. Artificial ear prostheses can be attached to the patient, either via a skin adhesive or osseointegrated craniofacial implants, or by a spectacle. The artificial ear prosthetics are made of a medical silicone or acrylic, which is coloured to match the natural ear skin tissue. The prosthetic ear normally improves hearing by about 20%13 and will retain spectacles, and a hearing aid, if needed. It also serves as a great psychological benefit in the rehabilitation of the patient.
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