Tragus Reconstruction

 

646. <Tragus Reconstruction>

The tragus is the small cartilage projection located at the front of the ear. Tragus reconstruction is performed when the tragus is absent, underdeveloped, or overly prominent.

But what role does the tragus play?
Evolved through mammalian development, the tragus helps collect sounds coming from the front and distinguishes them from those coming from behind, sharpening our ability to detect sound direction. It’s particularly important for recognizing the direction of high-frequency sounds and acts like a protective lid for the ear canal against dust and debris. In some cases, the tragus may be naturally missing or can be damaged, especially in women due to earrings or infections, leading to the need for surgery.

How is tragus reconstruction performed?
Cartilage—typically harvested from the ear or rib—is sculpted into the shape of a tragus and fixed into place. If there is insufficient skin, adjacent skin flaps or grafts are used.
For cases where the tragus is excessively prominent, a reduction is performed by trimming and reshaping it harmoniously with the ear.

Sometimes, abnormal tissue growths near the tragus (accessory tragus) or deformities (tragus malformation) occur. These may involve reconstructing the tragus’ natural curve and prominence through cartilage reshaping or grafting.
When the tragus is underdeveloped (hypoplasia), volume enhancement using nearby cartilage or harvesting cartilage from behind the ear can recreate a natural-looking tragus.

Complete absence of the tragus (aplasia) often accompanies microtia or ear canal anomalies. In these cases, a full ear reconstruction using rib cartilage is performed, including tragus creation, with skin rotated or grafted from the scalp or temple area.

The tragus is an essential functional and aesthetic structure — when necessary, it should be reconstructed to restore both beauty and precision in hearing.

"Tragus surgery is the art of rebuilding the protective pillar at the front of the ear that sharpens the directionality of sound."
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