Prosthetic rehabilitation offers an alternative to surgical procedures for repositioning implant-retained auricular prosthesis. This report illustrates a prosthetic rehabilitation of a 15-year- old male with a unilateral microtia who presented with an unfavorable implant-retained left auricular prosthesis. The implants placed seven years ago were drifted posterosuperior away from the ideal ear canal position. The fabrication of a new prosthesis on the existing bar-clip attachment using a custom acrylic base was planned to correct the location. A skin-colour perforated custom acrylic base was fabricated and designed to extend anteriorly, therefore, shifting the prosthesis forwards into a more natural location. The custom base was able to relocate the prosthesis’ position without compromising its retention whilst engaging the existing implant attachment. This in turn enhanced prosthesis acceptability and improved the patient’s confidence. The custom acrylic base serves as a viable option to reposition the prosthesis influenced by age related growth and development.

Objective: To analyse the clinical characteristics of patients with morbidly adherent placenta (MAP). Findings of this study will be used to identify patients at risk of MAP and to outline the best management strategy to deal with this devastating condition. Methods: Delivery records in Hospital Sultanah Nur Zahirah, Terengganu from 1st. January 2016 until 31st. December 2016 were reviewed and analysed. Results: Out of the 15,837 deliveries, eight cases of MAP were identified. Six out of eight patients had previous caesarean scar with concomitant placenta praevia, the other two patients had previous caesarean scar with history of placenta praevia in previous pregnancies. Seven out of eight cases were suspected to have MAP based on risk factors. Correct diagnosis was made by ultrasound in five patients, all with histologically confirmed moderate/severe degree of abnormal placentation. The other two cases of ‘unlikely MAP’, demonstrated segmental MAP intra-operatively with histologically confirmed milder degree of abnormal placentation. Total intraoperative blood loss ranged from 0.8 to 20 litres. Prophylactic internal iliac artery balloon occlusion was associated with significantly less blood loss. Conclusion: Antenatal diagnosis is essential in outlining the best management strategy in patients with MAP. Ultrasound may not be accurate in ruling out lower degree of MAP. Apart from having a scarred uterus with concomitant placenta praevia, history of having placenta praevia in previous pregnancy is also a risk factor for MAP. Prophylactic internal iliac artery balloon occlusion is associated with significantly less blood loss and should be considered in cases suspected with MAP.