How Important is the Tragus in Ear Reconstruction? An Eye-Tracking Study

Area of Science:

• Otolaryngology
• Plastic Surgery
• Ophthalmology

Background:

• The tragus is a key feature in auricular reconstruction, but its aesthetic significance is debated.
• Surgical creation of the tragus presents technical challenges in microtia repair.

Purpose of the Study:

• To investigate the visual attention directed towards the tragus and ear structures using eye-tracking technology.
• To compare gaze patterns on ears with and without a tragus in photographic stimuli.

Main Methods:

• Eye movements of 50 adults were tracked using Tobii Pro while viewing facial profile and ear close-up images.
• Images presented ears with and without a tragus, with gaze patterns analyzed via heat maps.
• Statistical analysis using t-tests compared attention to specific facial and ear areas.

Main Results:

• No significant difference in gaze duration on the ear was observed between profile views with and without a tragus (p=0.81).
• The tragus itself received minimal visual attention (0.19s) in close-up views.
• Absence of the tragus led to increased attention towards the ear canal (p=0.02).

Conclusions:

• The tragus does not significantly influence overall facial viewing patterns in microtia reconstruction.
• Increased exposure and attention to the ear canal when the tragus is absent may be a critical consideration for aesthetic outcomes.
• Findings may inform surgical planning and aesthetic targets in auricular reconstruction.