The intricacy and distinctiveness of the ear’s topography poses a particular challenge to the reconstructive surgeon. The skin of the ear differs by location, with the skin of the lateral surface being very thin and sensitive, while that of the medial surface is thicker, and very soft. Muscles of the ear, though serving very few purposes, are categorized as either internal or external auricular muscles. It is the internal auricular muscles that create the characteristic folds seen in the ear, while the external auricular muscles stabilize the entire ear. Arterial blood flow to the auricle relies on the superficial temporal artery and the posterior auricular artery, which together form an arcade that supplies blood to the helix. Sensory information from the external ear is carried by the great auricular nerve, the auricular branch of the vagus nerve, the auriculotemporal nerve, and the lesser occipital nerve, while motor innervation is provided by branches of the facial nerve. Possessing a thorough understanding of the anatomy presented herein, in addition to the anthropometric characteristics of a “normal” ear remains critical for surgeons performing ear reconstruction.
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