Reconstruction of the Ears

Ear reconstruction is challenging. The ear's limited tissue mobility, cartilage predominance, and its three-dimensional contour require creativity in flap design and a sense of proportion. Its rigid cartilage architecture can be advantageous in shallow defects as it prevents contractile distortion during second intention healing. An intact perichondrium will greatly facilitate vascularity and healing. Pre- and post-auricular tissue are excellent donor sites for local flaps based on the superior temporal and posterior auricular arteries respectively. Both single and staged flaps may accomplish excellent functional and aesthetic outcomes. Preventing notching and preserving the helical convexity is a priority in ear repair. Small asymmetries are usually unnoticeable given the ear's lateral location and concealment with hairstyles. With subtotal auricular loss, ear prosthetics simulate a natural restoration.