Surgical concepts for reconstruction of the auricle. History and current state of the art.

We compiled and evaluated the world literature on auricular reconstruction, for a total of over 400 publications, more than 200 authors, and over 3,300 reported cases. We found that partial reconstructions were already performed as early as 600 BC; total reconstructions were still considered impracticable in 1830. But since 1891, more than 40 different cartilaginous, osseous, and alloplastic frame materials have been described. Only eight of these were still being applied in the last decade, with autogenous costal cartilage and silicone as the leading substances. Results of the operation can be improved by special surgical manipulations, eg, the "fan-flap" technique. Taking into consideration the complication rate, the number of individual interventions, and the stability of the results, we devised a special point system that makes possible a limited assessment of the different surgical techniques.