CCA Auricular & Nasal Reconstruction 2 — Questions and Answers
Question 1: When fabricating an auricular prosthesis for a patient with microtia, which landmark is most critical for establishing vertical positioning?
- The lateral canthus of the eye
- The tragus of the contralateral ear
- The hairline posterior boundary
- The helical root level of the contralateral ear (Correct answer)
Correct answer: The helical root level of the contralateral ear
The helical root of the contralateral ear sets the superior-inferior position of an auricular prosthesis to ensure bilateral symmetry.
Question 2: Which intrinsic anatomical feature of the auricle is most difficult to replicate in silicone prosthetics and often requires post-processing?
- The lobule
- The antihelix bifurcation (Correct answer)
- The conchal bowl depth
- The tragal definition
Correct answer: The antihelix bifurcation
The antihelix bifurcation into the superior and inferior crura involves complex undercuts that are challenging to reproduce accurately in a removable silicone prosthesis.
Question 3: A patient presents with a total rhinectomy defect and significant scarring of the nasal floor. Which prosthetic retention strategy is most appropriate?
- Spectacle-mounted retention only
- Osseointegrated implants placed in the nasal bone remnants (Correct answer)
- Adhesive retention with a wide skin-contact flange
- Magnetic coupling to adjacent zygoma implants
Correct answer: Osseointegrated implants placed in the nasal bone remnants
Osseointegrated implants placed in stable bone remnants provide the most reliable retention when soft tissue scarring compromises adhesive surface area.
Question 4: During nasal prosthesis coloration, which technique best captures the appearance of nasal tip vascularity without adding excessive opacity?
- Surface painting with dense oxide pigments
- Intrinsic pigmentation using translucent washes of red and purple (Correct answer)
- Applying a commercial blush cosmetic over cured silicone
- Adding metallic flake to the silicone base
Correct answer: Intrinsic pigmentation using translucent washes of red and purple
Intrinsic translucent washes of red and purple pigments mimic subsurface vascularity, maintaining the depth and lifelike quality of nasal tip skin.
Question 5: What is the primary purpose of a wax trial fitting during auricular prosthesis fabrication?
- To determine the implant position for osseointegration
- To verify form, size, color, and retention before final processing (Correct answer)
- To create the definitive mold for silicone injection
- To train the patient in daily adhesive application
Correct answer: To verify form, size, color, and retention before final processing
A wax trial fitting allows the anaplastologist and patient to evaluate all esthetic and functional parameters before committing to the irreversible final material.
Question 6: Which sealant material is commonly applied to the edges of a nasal silicone prosthesis to feather the margins and blend with surrounding skin?
- Polymethylmethacrylate (PMMA)
- Intrinsic-matched medical-grade silicone adhesive (Correct answer)
- Zinc oxide eugenol paste
- Polyurethane foam strips
Correct answer: Intrinsic-matched medical-grade silicone adhesive
Intrinsic-matched medical-grade silicone adhesive is used to feather thin prosthetic margins, creating a seamless transition at the skin interface.
Question 7: When designing a bar-retained auricular prosthesis over two craniofacial implants, what is the minimum recommended implant spacing to allow adequate bar attachment and hygiene access?
- 5–7 mm center-to-center
- 10–14 mm center-to-center
- 18–22 mm center-to-center (Correct answer)
- 25–30 mm center-to-center
Correct answer: 18–22 mm center-to-center
A center-to-center spacing of approximately 18–22 mm is recommended to accommodate the bar connector hardware and allow adequate oral-hygiene-style cleaning around abutments.
CCA Auricular & Nasal Reconstruction 2
When fabricating an auricular prosthesis for a patient with microtia, which landmark is most critical for establishing vertical positioning?