Anatomy and Anthropometry of the Ear

  • Ari M. Wes
  • Jesse A. TaylorEmail author


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.


Ear anatomy Auricle Vasculature Innervation Lymphatics Anthropometric Morphometric 


  1. 1.
    Baker S. Local flaps in facial reconstruction. 3rd ed. Philadelphia: WB Saunders; 2014.Google Scholar
  2. 2.
    Middlebrooks JC, Green DM. Sound localization by human listeners. Annu Rev Psychol. 1991;42:135–59.CrossRefGoogle Scholar
  3. 3.
    Avelar JM. Ear reconstruction. Berlin/Heidelberg: Springer-Verlag; 2013.CrossRefGoogle Scholar
  4. 4.
    Fujino T, Harashina T, Nakajima T. Free skin flap from the retroauricular region to the nose. Plast Reconstr Surg. 1976;57:338–41.CrossRefGoogle Scholar
  5. 5.
    Siegert R, Weerda H, Remmert S. Embryology and surgical anatomy of the auricle. Facial Plast Surg. 1994;10:232–43.CrossRefGoogle Scholar
  6. 6.
    Hoogbergen MM, Schuurman AH, Rijnders W, Kon M. Auricular hypermobility due to agenesis of the extrinsic muscles. Plast Reconstr Surg. 1996;98:869–71.CrossRefGoogle Scholar
  7. 7.
    Yotsuyanagi T, Yamauchi M, Yamashita K, Sugai A, Gonda A, Kitada A, et al. Abnormality of auricular muscles in congenital auricular deformities. Plast Reconstr Surg. 2015;136:78e–88e.CrossRefGoogle Scholar
  8. 8.
    Zilinsky I, Erdmann D, Weissman O, Hammer N, Sora MC, Schenck TL, et al. Reevaluation of the arterial blood supply of the auricle. J Anat. 2017;230:315–24.CrossRefGoogle Scholar
  9. 9.
    Pan W-RR, le Roux CM, Levy SM, Briggs CA. Lymphatic drainage of the external ear. Head Neck. 2011;33:60–4.CrossRefGoogle Scholar
  10. 10.
    Peuker ET, Filler TJ. The nerve supply of the human auricle. Clin Anat. 2002;15:35–7.CrossRefGoogle Scholar
  11. 11.
    Sauter R, Villavicencio E, Schwager K. Doubling of the pinna, a rare branchial arch developmental disorder. Laryngorhinootologie. 2006;85:657–60.CrossRefGoogle Scholar
  12. 12.
    Anthwal N, Thompson H. The development of the mammalian outer and middle ear. J Anat. 2016;228:217–32.CrossRefGoogle Scholar
  13. 13.
    Pawar SS, Koch CA, Murakami C. Treatment of prominent ears and otoplasty: a contemporary review. JAMA Facial Plast Surg. 2015;17:449–54.CrossRefGoogle Scholar
  14. 14.
    Janis JE, Rohrich RJ, Gutowski KA. Otoplasty. Plast Reconstr Surg. 2005;115(4):60e–72e.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Children’s Hospital of Philadelphia, Division of Plastic SurgeryUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations