Int. Adv. Otol. 2009; 6(1); 1-6

Morphological characteristics of tragal cartilage.
Ibrahim Hizalan, Ugur Dokuzlar, Ilker Mustafa Kafa, Erdogan Sendemir 
Department of Otolaryngology, Uludağ University, Faculty of Medicine, Bursa, Turkey. ibrahim@hizalan.com

Objective: Aim of this study is to investigate possible anatomical variations as well as cartilage thickness and surface area that
can affect the utility of the tragal cartilage and perichondrium.
Background: Cartilage and perichondrial grafts are frequently used in tympanoplasties and middle ear reconstructions. One
of the most frequently used cartilage for this purpose is the tragus. Surgeons may face different anatomical characteristics of
this cartilage. Literature search has not yet revealed any study that has been performed to define morphological characteristics
of the tragal cartilage.

Material: A total of twenty tragi of ten adult cadavers were dissected for area and thickness measurements of cartilages.
Results: Our study showed that the cartilage tissue between borders of tragus and cartilaginis meatus acustici externi is
composed of two separate plates; one superolateral part which we named “surgical tragus” and a inferomedial part that we
called “tragal spare cartilage”, with the dividing line being incisura cartilaginis meatus acustici. However, we have observed that
this “incisura” was missing on two cartilages out of twenty. The greatest thickness was 2.20 mm on the inferior part of the
tragus. The thinnest part was the superior medial part of the tragus and was measured 0.7 mm. Our results have also indicated
that on average at most 2.19±0.53 cm2 of cartilage can be used as tragal reconstruction material. In cases where cartilage
harvested from tragus is insufficient, 1.36±0.67 cm2 of cartilage on the root of the external meatus is ready to be utilized as
reserve material.

Conclusion: Findings from the cadaveric tragus specimen show that there are no major pathological changes or conditions on
dissected cartilages. The cartilage tissue between borders of tragus and cartilaginis meatus acustici externi is composed of two
separate plates; one lateral part which we named “surgical tragus”, and a medial part that we called “tragal spare cartilage”,
ready to be utilized when the surgical tragus is not enough to serve the purpose.