CCA Auricular & Nasal Reconstruction 3 — Questions and Answers
Question 1: In nasal prosthetics, which anatomical zone is most critical to replicate accurately to avoid detection at conversational distances?
- The dorsal ridge
- The soft tissue triangle and alar-facial groove (Correct answer)
- The nasal tip projection
- The columellar length
Correct answer: The soft tissue triangle and alar-facial groove
The soft tissue triangle and alar-facial groove define the natural light-shadow interface at the base of the nose and are most scrutinized during face-to-face interaction.
Question 2: A patient with a partial auricular defect retains the tragus and conchal bowl. Which prosthetic design approach is most esthetically and functionally appropriate?
- Fabricate a full auricular prosthesis covering all remaining anatomy
- Design a partial prosthesis that integrates with and uses retained anatomy as a foundation (Correct answer)
- Recommend surgical reconstruction instead of a prosthesis
- Use a standard stock ear prosthesis trimmed to fit
Correct answer: Design a partial prosthesis that integrates with and uses retained anatomy as a foundation
A partial prosthesis designed to integrate with retained auricular anatomy maximizes esthetics, reduces prosthetic bulk, and may allow the natural tragus to aid retention.
Question 3: When using a facial mold to fabricate a nasal prosthesis, why must the nostril apertures be blocked with wax prior to impression taking?
- To prevent undercut formation in the nares that would lock the impression material (Correct answer)
- To maintain patient airway patency during the impression procedure
- To record the columellar contour without distortion
- To avoid contamination of impression material with nasal secretions
Correct answer: To prevent undercut formation in the nares that would lock the impression material
Blocking the nostril apertures with wax prevents impression material from flowing into the nares and creating undercuts that would make mold separation impossible.
Question 4: Which pigment behavior difference must the anaplastologist account for when coloring platinum-cured silicone versus peroxide-cured silicone prostheses?
- Platinum silicone darkens significantly upon cure; peroxide silicone does not
- Peroxide silicone is inhibited by nitrogen pigments; platinum silicone accepts all pigments
- Platinum silicone is inhibited by sulfur-containing pigments; peroxide silicone is less sensitive (Correct answer)
- Peroxide silicone requires UV-stable pigments; platinum silicone does not
Correct answer: Platinum silicone is inhibited by sulfur-containing pigments; peroxide silicone is less sensitive
Sulfur-containing pigments (some cadmium-based colors and certain cosmetic pigments) inhibit platinum catalyst curing, leaving uncured, sticky silicone in affected areas.
Question 5: What is the primary advantage of using a three-piece mold over a two-piece mold for auricular prosthesis fabrication?
- It reduces material cost by using less silicone
- It eliminates flash lines in cosmetically critical zones such as the helix (Correct answer)
- It allows for faster cure time
- It is required for all implant-retained auricular prostheses
Correct answer: It eliminates flash lines in cosmetically critical zones such as the helix
A three-piece mold is designed so that parting lines fall in less visible areas, reducing the need for trimming and blending on the exposed helix rim.
Question 6: A nasal prosthesis patient reports that their prosthesis lifts at the superior margin during facial animation. Which modification is most likely to correct this?
- Increase the overall thickness of the prosthesis body
- Thin and extend the superior flange and apply a bonding primer to the skin (Correct answer)
- Switch from medical adhesive to a spectacle retention system immediately
- Add intrinsic weight to the prosthesis to resist upward movement
Correct answer: Thin and extend the superior flange and apply a bonding primer to the skin
Thinning the superior flange reduces resistance during animation while extending its footprint, and a bonding primer enhances adhesive bond at the most mobile margin.
Question 7: Which post-auriculectomy defect characteristic most strongly predicts the need for osseointegrated implant retention rather than adhesive retention?
- Patient age over 65
- Loss of periauricular soft tissue with radiation-induced fibrosis (Correct answer)
- Defect involving only the upper one-third of the auricle
- Patient preference for ease of daily removal
Correct answer: Loss of periauricular soft tissue with radiation-induced fibrosis
Radiation-induced fibrosis reduces skin elasticity and adhesive bond strength, making adhesive retention unreliable and osseointegrated implants the preferred alternative.
CCA Auricular & Nasal Reconstruction 3
In nasal prosthetics, which anatomical zone is most critical to replicate accurately to avoid detection at conversational distances?