Craniofacial defect rehabilitation: long-term outcomes of implant-retained ear, nasal, and orbital prostheses – the Morriston experience

Abstract

This retrospective study assessed the long-term outcomes of extraoral craniofacial implants used to support auricular, nasal, and orbital prosthesis in 138 patients treated at Morriston Hospital, Swansea, from 2004 to 2024. A total of 346 implants were reviewed, showing an overall implant survival rate of 91.9% and prosthesis survival rate of 89.6%. Long-term survival rates at 5, 10, and 20 years were highest for ear implants (100%, 90%, and 80%), respectively, followed by nasal (95.2%, 91.8%, and 91.8%) and orbital implants (89%, 86.6%, and 77%), respectively. Radiotherapy was associated with poorer implant survival, with a survival rate of 89.3% in irradiated implants compared with 97% in non-irradiated implants (p = 0.0219). Amongst the irradiated implants, those placed during ablative surgery showed a significantly improved survival rate (92.49%) than those placed following radiotherapy (68.42%, p = 0.0069). Emerging plating systems such as Epitek show promise in providing alternative nasal prosthesis retention but require further long-term follow up. The above findings underscore the necessity for careful planning alongside experienced lab technicians to optimise implant placement and enhance the long-term success of craniofacial prosthesis.