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The artwork of making the epithesis by the dedicated anaplastologist is the prerequisite of acceptance by the patient and the key for success of this approach. However, computer science is helping with virtual planning and rapid prototyping, and it is likely to revolutionize this process in the near future. One of the advantages of the auricular prostheses is that it can be manufactured as a mirrored replica of the opposite side (if normal or near normal). Furthermore, the results are predictable, and may be shown to the patient before surgery. The developments of various implant systems allow secure retention even in unfavorable anatomic situations as in the ideally pneumatized mastoid process. The advantage of the plate systems is that they spread the loading forces to multiple smaller bone screws, rendering it thereby resistant to torque with abutment insertion or magnet change. Auricular prostheses fulfill three roles: (1) temporary measure, (2) rescue procedure in failed auricular (re)construction, and (3) definitive treatment option. Conventional retention by medical adhesives, sometimes helped by making use of the remnant, keeps its place in the use as a temporary measure or if the patient declines surgery. Today, implant-retained auricular prostheses made of silicone are state of the art for prosthetic rehabilitation of patients with auricular defects., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

An ear episthesis is an artificial substitute for the auricle. The term EAR PROSTHESIS is used synonymously. The breakthrough came with the introduction of the modern silicones and their colorings. Although there are still indications for noninvasive methods of retention such as medical adhesives, the best and most reliable method of fixation is by bone anchorage. Long-lasting osseointegration with reaction-free skin penetration can be achieved with titanium implants. The first system used extraorally was the Brånemark flange fixture. Later, different solitary titanium implants were introduced, such as the ITI system. A different strategy used the titanium grids (Epitec) or plates (Epiplating) derived from osteosynthesis systems. These systems are fixed subperiosteally with several bone screws and are therefore also labeled as grouped implants. With these modern developments, secure retention can be achieved also in unfavorable anatomic situations. The grouped systems are resistant to torque with abutment insertion. The latest development is the subcutaneously implanted double magnet without skin penetration. The advantages of implant retained ear epistheses include optimal camouflage, predictable cosmetic results, fast rehabilitation, no donor site morbidity, and early detection of tumor recurrence. Depending on the clinical setting, prosthetic rehabilitation may be more than just an alternative to plastic reconstructive surgery., (Copyright Thieme Medical Publishers.)