Several surgical solutions have been proposed for reconstruction of the auricle in patients whose ear is missing as a result of a traumatic accident, cancer resection, or a congenital condition. These include insertion of an autogenous rib cartilage framework or a porous polymeric material into an expanded postauricular pocket. Reconstruction with rib cartilage has given good results, but requires more than one surgical step and adverse events can occur at both the donor and acceptor site, while cases of prosthesis rejection have been described following application of polymeric prostheses with the expanded postauricular pocket technique. The use of a titanium dowel-retained silicone prosthetic pinna, fixed to temporal bone, has recently been proposed. This surgical technique is particularly indicated after resection of the pinna in cancer patients and in cases of traumatic auricular injury. Bone-anchored titanium implants provided the 15 patients in this study with a safe, reliable, adhesive-free method of anchoring auricular prostheses. The prostheses allowed recovery of normal appearance and all patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered.
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