Tartu University Hospital and Pallas University of Applied Sciences have collaborated to provide a patient with a unique ear prosthesis, or epithesis. The operation was the first of its kind in Estonia and could expand treatment options for other patients in the future. The epithesis was developed as part of the graduation project of Pallas student Viktor Kiss.
The 12-year-old patient who underwent the procedure was born without an external ear. According to the patient’s treating physician, Dr Raiko Tiganik, a successful treatment plan required several surgical procedures, carried out in parallel with the development of the ear epithesis by Pallas student Viktor Kiss.
The first operation took place on 11 September 2025 at the Ear Clinic of Tartu University Hospital, during which implants were placed in the patient’s temporal bone. The process is similar to dental implantation, where screws are inserted into the bone. The patient then needs up to six months to recover and allow the implants to integrate with the bone. This waiting period is also necessary for the body to accept the metal implants
Dr Raiko Tiganik the patient’s treating physician, who performed Estonia’s first operation of this kind
The operation was successful, with careful planning and international cooperation playing a key role. The collaboration was coordinated by Pallas student Viktor Kiss. “During the planning stage, we also consulted Dr Peter Evans from the United Kingdom to determine the precise locations for the screws. We also used a 3D-printed surgical guide during the operation, made possible through the support of the hospital’s maxillofacial surgeons and dental laboratory,” Dr Tiganik explained.
After the six-month healing period, a second operation was performed to attach posts to the integrated implants beneath the skin. “The posts are metal cylinders that extend through the skin and are needed to attach the ear epithesis magnetically,” Dr Tiganik added.
The ear epithesis, or prosthesis, was created as the graduation project of final-year Pallas student Viktor Kiss. The development process lasted almost a year, was divided into three stages and progressed in parallel with the patient’s treatment. Kiss used 3D scanning, digital modelling, manual sculpting, silicone casting and individualised combined pigmentation to achieve a highly natural and accurate result.
This interdisciplinary initiative is more than just a graduation project for me. The project gave me the opportunity to combine my previous medical education with my sculptural practice and, in doing so, provide real help to a child. It shows that art can be part of clinical rehabilitation and can directly affect a person’s quality of life
Viktor Kiss, final-year Pallas student who created the ear epithesis, or prosthesis as the graduation project.
The patient’s first ear epithesis was delivered on 4 May 2026, with a second prosthesis planned.
According to Dr Raiko Tiganik, the use of implants integrated into the bone is a first in Estonia, as epitheses and facial prostheses have long been an area not covered by the country’s healthcare system.
We are pleased to have taken the first steps towards combining the best possibilities of surgery and prosthetics to provide patients with effective treatment. The pilot project was successful. Implant placement with magnetic attachment is a highly modern method, and this result cannot be achieved using the silicone adhesives previously used. The same method could also be used in the future for patients with partial or complete absence of the external ear, as well as in cases resulting from trauma or tumours. The next steps will include adding the service to the Estonian Health Insurance Fund’s list of reimbursed healthcare services and finding a cooperation partner whose products are registered as medical devices.
Dr Raiko Tiganik
As this type of ear epithesis and facial prosthetics has not previously been developed in Estonia, Viktor Kiss plans to continue working in the field and establish an epithesis laboratory equipped with the necessary materials and resources for surgeons and patients.
“I am very positive about the future and feel more confident because I have had the opportunity to work in a unique team, where every member has a great and caring heart and is genuinely committed to helping others. Without their support and contribution, this project would not have been possible. It was their professionalism, care and willingness to work together that made it possible to turn this idea into reality,” Kiss added.
Pallas alumni Liina Kinks and Iris Müntel also contributed to the development of the epithesis. Dr Oksana Ivask from Tartu University Hospital provided consultation, alongside international experts Dr Peter Evans and Jörn Brom. Companies Southern Implants and Technovent also contributed to the project.
As this is an innovative treatment method, it has not yet been included in the Estonian Health Insurance Fund’s list of reimbursed healthcare services.
The costs of the first operation were therefore supported, among others, by the Children’s Foundation and donors who responded to an appeal accompanying Viktor Kiss’s installation at the “Frequently Asked Questions” art exhibition.
