J Craniofac Surg. 2026 Sep 15. doi: 10.1097/SCS.0000000000013393. Online ahead of print.
ABSTRACT
Auricular reconstruction encompasses both prosthetic and surgical methodologies, each requiring a distinct combination of scientific knowledge, manual skill, and aesthetic judgment. This narrative review traces the evolution of craft skills across both disciplines, from their earliest recorded applications to contemporary digital and tissue-engineering approaches. A narrative review was conducted using PubMed/MEDLINE, Scopus, Embase, and Google Scholar (August 2025-February 2026). Searches combined MeSH and free-text terms across auricular anatomy, autologous and alloplastic reconstruction, prosthetic rehabilitation, and emerging technologies. Contemporary literature was prioritized and supplemented by targeted hand-searching for landmark historical publications. Prosthetic materials have advanced from ivory and wax to contemporary silicones, while surgical techniques have progressed from simple skin flap transposition to the refined rib-carving protocols of Tanzer, Brent, and Nagata, and the alloplastic frameworks of Cronin and Reinisch. Each advance has introduced new demands of sculpting precision, vascular judgment, and chromatic accuracy. Auricular reconstruction inherently amalgamates art and science, with aesthetic judgment inseparable from technical skill in both disciplines. Emerging technologies, including CAD-CAM and three-dimensional printing, reduce specific manual steps but do not displace overall craft skill. No single modality is universally superior. Selection must be individualized to the patient's age, anatomy, hearing status, and available expertise. Auricular reconstruction remains a subspecialty in which technical skill, scientific knowledge, and aesthetic understanding are inseparable. Emerging technologies are best evaluated by whether they improve patient outcomes rather than by whether they simplify the craft itself.
PMID:42743550 | DOI:10.1097/SCS.0000000000013393