Use of Tragal Cartilage Grafts in Rhinoplasty: An Anatomic Study and Review of the Literature

Abstract

We conducted a cadaveric study to determine the size of cartilage grafts that can be taken from the tragus without distorting tragal anatomy. Our subjects included 7 fresh cadavers—3 male and 4 female (age at death: 61 to 87 yr). Tragal cartilage grafts were harvested while leaving the lateral 3 mm of the tragal cartilage in situ to preserve the anatomic shape of the tragus. The grafts were measured and their dimensions recorded. The craniocaudal dimensions of the tragal cartilages ranged from 15 to 30 mm (mean: 21.6), and the width of each specimen ranged from 10 to 23 mm (mean: 15.3). The thickness of the cartilage was approximately 1 mm. The grafts were slightly curved along their long axis. We also review the literature regarding the dimensions of different grafts used in rhinoplasty, knowledge of which can help in preoperative planning. Tragal cartilage grafts have been used as shield, alar contour, alar batten, lateral crural onlay, dorsal onlay, and infratip lobule grafts. When a straight and/or thick graft is needed, two strips of tragal cartilage can be sutured in a mirror-image configuration.