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SINCE NONE OF THE ARTIFICIAL MATERIALS CAN REPLACE HUMAN TISSUES, DR. MUTAF USES ONLY PATIENTS OWN TISSUES in EAR RECONSTRUCTION.
As a doctor and father, throughout my professional life, I always asked the question, "WOULD I PERFORM THIS SURGERY IF THE PATIENT WAS MY OWN CHILD?" when making decisions about the surgeries that I will perform on my pediatric patients. Because of my belief in this moral value, I always refrained from applying new methods on my patients that have not been proven to be safe and effective in clinical studies. When I consider the methods available today for auricular reconstruction from the same point of view, I decided not to use the auricular implants made from polypropylene, which is a petroleum-derived substance and for which serious side effects have been reported in unbiased clinical studies. Although as scientists we are continuing our studies to construct an auricle by producing an "artificial cartilage" from stem cells in order to create an alternative for ear construction other than these artificial materials that do not adjust with the human body, the results of ear constructions performed by transplanting cartilage models produced in the laboratory in the form of ears into the human body are unfortunately also not at the desired level yet.
TODAY, THERE IS NO ALTERNATIVE SOLUTION TO REPLACE AN AURICLE CONSTRUCTED WITH A PERSONS OWN TISSUES, yet
In order to find the answers to your questions about this topic, please carefully read the summary below, which reflects the results of international scientific studies, and look at the table comparing natural cartilage and artificial implant methods.
The methods of auricular reconstruction used for children born with microtia are mainly divided into two groups as "alloplastic" methods, which primarily use artificial materials, and "autologous" methods, in which the ear of the patient is reconstructed using patients own tissues. Easy solutions with artificial methods have been researched for many years in microtia treatments, however, none of these solutions, such as prosthetic ears that are inserted and removed, or artificial auricle implants that are placed under the skin, are methods that can be compared with an auricle made from a persons own tissues.
There is no sensibility in artificial ear prostheses that are glued on the skin or attached to the bone with screws; they create a feeling of a foreign body on the face. They can lead to stubborn infections and non-healing wounds. Moreover, since the patient cannot lie on it for life and needs to take it off every evening before going to bed, they cause the patient to face their deformity again and again. Due to these disadvantages, they have not gained widespread use.
Although ear implants were developed to create an easy alternative to ear construction with humans own tissues, scientific clinical studies have revealed that they have serious side effects. In order to objectively evaluate the options for ear reconstruction, it is necessary to know these side effects in detail. As a doctor who has seen hundreds of patients who have permanently lost the chance of a new ear reconstruction due to complications of ear implants.I believe that implant applications should be avoided in ear reconstruction. Please read carefully the information given below about the side effects of ear implants.
Every material placed in the body, except for a persons own tissues, sooner or later creates a foreign body reaction, and this reaction continues with repeated infections until it is eliminated from the body. Implants placed in a protruding organ such as an ear, especially under a thin tissue cover, will inevitably be expelled from the body due to a foreign body reaction, recurrent inflammations and skin decay in the long term.
In polyethylene-derived ear implants such as Medpor, Supor, there is a significant risk of fracture during sporting activities due to the fact that they are rigid and inelastic plastic substances. In case of a fracture, it is not possible to repair it, and the patient has to undergo another extremely laborious surgery for the replacement of the implant.
HE FRACTURE RATE EXPRESSED BY THE PHYSICIANS USING IMPLANTS IS 7% THIS RATIO CAN BE MUCH HIGHER IN REALITY.
| QUESTION | CARTILAGE METHOD | POLYPROPYLENE IMPLANTS |
|---|---|---|
| WHAT IS THE EARLIEST AGE OF SURGERY? | 5 | 4 |
| NUMBER OF SURGICAL STAGES | 2 | MORE THAN 1 IN USUAL |
| HEALING TIME? | 2 WEEKS | MINIMUM 6 MONTHS |
| RISK OF FRACTURE | NONE | YES > 6% |
| NEED FOR SPECIAL CARE (Moisturizers, sunblokers, topical cortisone etc.) | NO NEED | LIFE TIME |
| FLEXIBILITY AND SPORTS WITHOUT PROTECTION | YES | NO |
| SENSIBILITY | NORMAL | NO OR LIMITED, NEVER FEELS LIKE A NORMAL EAR |
| RISK OF REJECTION? | NO | YES, FOREVER. |
| IS SLEEPING OVER THE NEW EAR POSSIBLE without any special set up? | YES | NO |
| RISK of SKIN breaks AND EXPOSION IN LATE TERM | NO | YES ﹥%12 |
| POSTOPERATIVE HAIR LOSS | NO | YES |
| SURCICAL SCAR ON THE ARM OR ABDOMEN | NO | YES - UGLY SCARS |
| AESTHETIC QUALITY - the new ear to be similar with the normal ear? | INDIVIDUAL DESIGN LOOKS LIKE NORMAL EAR | SAME PREFABRICATED SHAPE IN EVERY PATIENT - NO SIMILARITY WITH THE CONTLARATERAL NORMAL EAR |
| GROWTH POTENTIAL | YES | NO |
| ANY PROBLEM IN COLD WEATHER? | NO | CIRCULATION PROBLEMS SKIN NECROSIS |
| IS A SALVAGE PROCEDURE WITH TPF FLAP POSSIBLE IF SOMETHING GOES WRONG?? | YES | NO - IF IT FAILS THERE IS NO MORE CHANCE OF EAR RECONSTRUCTION. EAR PROSTHESIS WILL BE THE ONLY CHOICE. |
| POSITIONAL CHANGE IMPLANT PTOSIS | NEVER | REMARKABLE RISK |
| QUALITY OF SKIN COVERAGE | NORMAL EAR SKIN | GRAYISH AND DRY SKIN GRAFT HARVESTED FROM ARM and/or ABDOMEN (NO TEXTURAL AND COLOR MATCH) |
| HOW LONG AFTER SURGERY CAN WE GO HOME ? | 1 WEEK | 4-5 WEEKS |
| PRICE COMPARISON | 1 | X4 |
According to the results of the scientific studies summarized in the table and images above, we can see that the auricles constructed with artificial implants will cause problems for the patient sooner or later due to side effects.
A NEW EAR THAT WILL NOT CAUSE PROBLEMS for LIFETIME IS ONLY POSSIBLE WITH the USE of PATIENTS OWN TISSUES
