Pallas and Tartu University Hospital Collaborate on Innovative Ear Prosthesis Project

A unique ear prosthesis (epithesis) was created for a patient through a collaboration between Tartu University Hospital and Pallas University of Applied Sciences. The procedure marks the first use of a bone-anchored, implant-retained ear prosthesis in Estonia and opens new possibilities for the treatment and rehabilitation of future patients. The prosthesis was developed as part of the final project of Pallas UAS student Viktor Kiss.

The 12-year-old patient was born without an external ear, requiring a long-term treatment plan that combined surgical procedures with the creation of a custom-made prosthesis. According to Dr Raiko Tiganik, otologist and lecturer at Tartu University Hospital, the treatment process began in September 2025, when implants were placed in the patient’s temporal bone. Similar to dental implants, the procedure involved inserting titanium fixtures into the bone, followed by a healing period of up to six months to allow osseointegration and tissue recovery.

Careful planning and international collaboration played a crucial role in the success of the project. During the planning phase, the team consulted Dr Peter Evans from the United Kingdom to determine the optimal implant positions. A 3D-printed surgical guide, produced with the support of the hospital’s maxillofacial surgeons and dental laboratory, was also used during the procedure.

Following the healing period, a second operation was performed to attach abutments to the osseointegrated implants. These metal posts extend through the skin and provide the attachment point for the magnet-retained prosthesis.

The ear prosthesis itself was designed and fabricated by Viktor Kiss over the course of nearly a year. The process combined 3D scanning, digital modelling, sculptural hand-modelling, silicone casting, and custom pigmentation techniques to achieve a highly realistic result.

“For me, this interdisciplinary initiative is much more than a final project,” said Kiss. “It provided an opportunity to combine my previous medical education with my sculptural practice and, in doing so, offer meaningful help to a child. The project demonstrates that art can be part of clinical rehabilitation and have a direct impact on a person’s quality of life.”

The patient received the first prosthesis on May 4, 2026, and a second prosthesis is planned.

According to Dr Tiganik, the use of bone-anchored implants for retaining facial prostheses has not previously been available in Estonia, where epitheses and facial prosthetics have remained an underdeveloped area of healthcare. He noted that the successful pilot project demonstrates the potential of combining contemporary surgical techniques with advanced prosthetic solutions. Compared to silicone adhesives used in the past, magnetic retention offers a significantly more reliable and comfortable outcome for patients.

The same approach could be used in the future for patients with partial or complete absence of the external ear, as well as for individuals affected by trauma or cancer-related tissue loss. Further development of the service will require both healthcare funding mechanisms and cooperation with manufacturers whose products are registered as medical devices.

As this type of ear prosthesis fabrication and facial prosthetic rehabilitation has not previously been available in Estonia, Viktor Kiss intends to continue working in the field and establish a specialised epithesis laboratory equipped to support both surgeons and patients.

In addition to Kiss, the project involved Pallas alumni Liina Kinks and Iris Müntel. Medical consultations were provided by Dr Oksana Ivask of Tartu University Hospital, while international expertise came from Dr Peter Evans and Jörn Brom. The companies Southern Implants and Technovent also contributed to the project.

Kiss’s final project, Development and Implementation of a Magnet-Retained Ear Epithesis within an Interdisciplinary Project in the Estonian Context, was supervised by Andreas Ventsel and Dr Oksana Ivask.

As this innovative treatment approach has not yet been included in Estonia’s public healthcare reimbursement system, the costs of the first operation were supported by several donors, including the Children’s Foundation. Additional contributions were made following a public fundraising initiative connected to Viktor Kiss’s installation at the exhibition Frequently Asked Questions.

Coverphoto: Epithesis. Photo Liina Kinks.