Background: Auricular carcinomas often require extensive surgical resection, resulting in complex three-dimensional defects,in some cases involving mastoid process exposure. Reconstruction aims to restore contour, protect underlying structures, and maintain patency of the external auditory canal (EAC). Case presentation and methods: We present a 45-year-old male patient, without comorbidities, who underwent subtotal auricular resection and wide retroauricular excision for basal cell carcinoma, resulting in mastoid bone exposure. Reconstruction was achieved using a temporal muscle flap covered by a skin graft, combined with a Z-plasty of the external auditory meatus to prevent postoperative stenosis. Recovery was uneventful, and 4 year follow-up demonstrated stable structural outcomes, preserved diameter of the meatus, without recurrence of the disease.The patient is prepared for autologous or prosthetic auricular reconstruction. Conclusion: A temporalis muscle flap with skin graft coverage offers a reliable, vascularized solution for large post-oncologic auricular defects while preserving the external auditory canal. Z-plasty remains a critical technique for preventing meatal stenosis.