A Hybrid Workflow for Auricular Epithesis: Proof of Concept Integrating Mold Design and the Virtual Patient

Abstract: Auricular epitheses play a vital role in restoring facial symmetry and patient confidence following congenital or acquired defects. Traditional wax-based fabrication is labor-intensive and lacks reproducibility. This study proposes and evaluates a simplified, digitally driven workflow for auricular prosthesis manufacturing, integrating virtual patient creation, mirrored ear design, and three-part mold fabrication using two design platforms—CATIA V5R21 (industrial CAD) and Blender (open-source graphics software). Key outcomes include mold reusability, patient-centered evaluation, and workflow feasibility. Methods: A 28-year-old female patient with right-sided microtia was selected. A light-based 3D facial scan was performed, and the intact contralateral ear was mirrored and adapted virtually to the defect site. Molds were designed in both CATIA and Blender using a standardized three-parallelepiped approach and printed using FDM technology (Elegoo Neptune 4 Plus). Five silicone epitheses were carefully fabricated with each mold. Surface trueness was evaluated with Geomagic Control X, while subjective assessments were conducted by an independent prosthetic team and the patient using Visual Analogue Scales (VAS). Results: Both design workflows resulted in clinically usable prostheses. No statistically significant difference in RMS deviation was observed (p = 0.53), although CATIA-derived epitheses achieved higher subjective scores (mean 9.22/10) compared to Blender (mean 7.67/10). The preferred prosthesis (CATIA) was selected for final pigmentation and delivery to the patient. All molds were reused five times without any structural damage or significant signs of wear. Conclusions: This study demonstrates that both CATIA and Blender can support an effective, patient-centered digital workflow for auricular prosthesis fabrication. The methodology enables reproducibility, mold reusability, and improved clinical accessibility of custom prosthetics.

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