Dental impression compound as an effective splint for maintenance of ear elevation in microtia reconstruction

Abstract

Ear projection is an important goal to be achieved after stage two (ear elevation) in cases of microtia. This is a retrospective study conducted on patients with microtia who underwent staged reconstruction for the same. This study has been carried out over a period of 10 years with 211 patients. Dental impression compound was used as a splint after ear elevation and split skin grafting to maintain the projection of the ear. Projection of the ear was measured both pre- and post-procedure and at every follow-up using goniometer and photographic documentation was simultaneously done. Statistical analysis was performed using t-test. Patients were reviewed every month and splint was continued until 6 months post-surgery. The splint was very effective in maintaining the ear projection of more than 20° even after prolonged follow-up of upto 2 years. There were no complications associated with the splint application or prolonged use.

(Y)ears of Freedom? Customized Splints in Microtia Reconstruction to Maintain Cephloauricular Angle

“…Though dental moulds have been routinely used in various studies for the same purpose, firm long-term anchorage of the mould in the retroauricular space was not accomplished, which led to frequent falling and breakage of the splint. 1 This problem was not seen with these customized splints. Silicon foley catheter splints could be used only in patients with intact external auditory meatus.…”

“…Numerous splints have been described for maintaining the retroauricular space after ear framework elevation in microtia surgery. 2 These range from simple conventional dental moulds, 1 acrylic based resins, 2 silicon Foleys catheter, 3 and thermoplastic materials, to dressing techniques 4 and spectacle frames. 5 These have limited application owing to scarce availability, difficult compliance, cost, and the necessity to replace daily under supervision.…”

“…Maintaining ear projection is essential after second-stage microtia reconstruction. 1 Preservation of cephaloauricular sulcus from obliteration following graft contracture is a challenge. 2 An effective splint should maintain the necessary auricular projection.…”

Role of dental impression compound in plastic surgery: Know more about it

“…I read with much interest an article entitled ‘dental impression compound as an effective splint for maintenance of ear elevation in microtia reconstruction’[ 1 ] published in your esteemed journal. I was elated to know that the impression compound material, which we routinely use in dentistry to make preliminary intraoral impressions of edentulous jaws; has its valuable application in the field of plastic surgery as well.…”

“…It satisfies all the criteria for the ideal soft tissue substitute. [ 3 ] However, it can be a potential cause of iatrogenic burn injury if used carelessly and if Bhandari and Singh[ 1 ] would have known that the impression compound is also available in brown (skin shade), they would have definitely used the brown coloured cake instead of red cake, so as to provide better aesthetics in 6 months postoperative period

Figure 1 Different colours and forms of impression compound

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