Craniofacial Prosthetic Reconstruction: A 25-Year Anaplastology Experience

BACKGROUND: Craniofacial anaplastology provides prosthetic rehabilitation that restores form and function in patients with congenital, traumatic, or oncologic defects. Despite advances in osseointegration and material science, large-scale data describing adult populations remain limited. OBJECTIVE: To characterize the demographic, clinical, and socioeconomic features of adult patients treated at a tertiary anaplastology center and evaluate whether socioeconomic status influences service utilization or outcomes. MATERIALS AND METHODS: A retrospective review was conducted of 1057 adult patients treated over 25 years, of whom 333 received at least one auricular prosthesis. Variables included age, sex, diagnosis, laterality, implant use, mortality, and geographic distribution. Residential ZIP codes were classified as high-, middle-, or low-income using state and national benchmarks. Associations between categorical variables were assessed using χ2 testing, and continuous-ordinal relationships with Spearman's rank correlation. RESULTS: The mean age was 52.1 years. Auricular defects accounted for 30.8% of all cases, with males comprising 76.3%. Diagnoses included congenital microtia (38.1%), trauma (33.3%), and cancer-related defects (28.6%), with squamous cell carcinoma representing the most common oncologic cause (12.9%). Laterality was right in 49.8%, left in 40.0%, and bilateral in 10.2%. Implants were used in 43.6% of cases. No significant differences were observed in prosthetic service utilization (χ2=1.89, P=0.388) or mortality (χ2=0.16, P=0.92) across earning classes. CONCLUSIONS: Adult anaplastology serves a diverse population spanning congenital, traumatic, and oncologic etiologies. Socioeconomic status was not associated with receipt of prosthetic services, implant use, or mortality, indicating equitable outcomes once specialized care is accessed.