Background: Microsurgical replantation of an avulsed auricle remains a chal
lenge in reconstructive surgery. Secondary reconstruction of a traumatic lo
st auricle is usually performed using a costal cartilage framework accordin
g to well documented techniqes or with a prosthesis. In order to minimize d
onor-site morbidity, various efforts can be undertaken to preserve the ampu
tated auricle by implanting the deepithelialized cartilage framework in a s
ubcutaneous pocket on the surface of the mastoid. Where preservation is suc
cessful, this original cartilage could be used for reconstructive treatment
. Patient and Results: This study describes the histologic and immunohistol
ogic changes in a complete traumatic avulsion of the auricle with subsequen
t cartilage conservation for eight months within a skin pocket. Trauma, pre
paration and preservation were accompanied by morphologic changes that incl
uded generation of local ossification centers and infiltration of fibrous t
issue. We compared the macroscopic and microscopic morphology of the amputa
ted part to native elastic cartilage following maximal denutrition and temp
orary heterotopic implantation in conjunction with atypical tension and pre
ssure properties of the retroauricular pocket. Conclusion: In this case, th
e limited success of cartilage conservation in the subcutaneous pocket requ
ired conventional auricle reconstruction with autologous costal cartilage.