title: Total Auricular Rehabilitation: Combined Cosmetic and Functional Lateral Temporal Bone Reconstruction.
abstract: OBJECTIVE
  The aim of the study was to describe 3 cases of total auricular rehabilitation, including the novel use of iliac crest bone grafts to support bone-anchored auricular prostheses.
  
  
  METHODS
  This study is a retrospective case series from a single institution.
  
  
  RESULTS
  Three cases with large lateral temporal bone and soft tissue defects were successfully treated with total auricular rehabilitation. Rehabilitation included the following: soft tissue coverage with an anterolateral thigh microvascular free flap, iliac crest-free bone graft with staged placement of a bone-anchored auricular prosthesis into the bone graft, and audiologic rehabilitation with a bone-anchored hearing aid (BAHA). All of the cases with grafts and flaps survived and were without significant donor site morbidity. Bone-anchored hearing aid abutment skin overgrowth was seen in 2 cases and was revised under local anesthesia. All of the patients had expected functional recovery on postoperative audiologic testing. Each patient continues to consistently wear his/her auricular prosthesis and BAHA during 3 years of follow-up.
  
  
  CONCLUSIONS
  Total auricular rehabilitation is a complex task involving reconstruction of extensive soft tissue defects, bony defects, and the hearing apparatus. Acceptable cosmetic and functional outcomes and high patient satisfaction is possible in committed patients.
authors.affiliation: *Department of Otolaryngology, Tripler Army Medical Center, Honolulu, HI †Department of Otolaryngology ‡Department of Maxillofacial Prosthetics, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Littlefield
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Tolisano
authors.forename: Jennifer V
authors.initials: JV
authors.lastname: Sabol
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Herberg
authors.forename: George L
authors.initials: GL
authors.lastname: Coppit
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000534:rehabilitation*; D004423:Ear; D058752:Free Tissue Flaps; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000534:rehabilitation*; D012189:Retrospective Studies; D053441:Suture Anchors; D013701:Temporal Bone / Q000601:surgery*; D055815:Young Adult