Auricular reconstruction, known as the "surgical art," is one of the most difficult and complex surgeries in medicine. There are two different techniques that involve either the use of artificial material like porous polyethylene (PE) or the patient's own rib cartilage graft. The patient's indication, age, conditions requiring previous failed surgeries, and the surgeon's skill in creating the frame are the most important factors in the choice of technique. Both methods are performed in our clinic in Vienna. We experienced more complications in the early cases using PE due to surgical inexperience. The advantages of PE, such as the fact that it is a single-stage surgery, favorable aesthetic appearance (definition and projection), and the possibility of combining the reconstruction with bone conduction devices or active middle ear implants and performing in older patients, can be compared with its disadvantages, such as greater complications. Both techniques require the acquisition of considerable skill and tricks, and for this reason it is important that a skilled surgeon who has mastered these auricular reconstruction skills is available to teach the next generation.
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