title: Long-term follow-up of osseointegrated auricular reconstruction.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Edmonton, Alberta, Canada From the Division of Plastic Surgery, Department of Surgery, University of Alberta, and the Institute for Reconstructive Sciences in Medicine, Misericordia Hospital.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Korus
authors.forename: Josh N
authors.initials: JN
authors.lastname: Wong
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Wilkes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D000013:Congenital Abnormalities / Q000601:surgery; D065817:Congenital Microtia; D004423:Ear / Q000002:abnormalities / Q000601:surgery; D054644:Ear Auricle / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D016348:Osseointegration; D017060:Patient Satisfaction; D019736:Prostheses and Implants; D055815:Young Adult