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

Abstract

Background:

Creating a tragus in microtia reconstruction is technically difficult, and its importance as a visual landmark is uncertain.

Objective:

To compare the attention given to ears in photographs with and without a tragus, as measured by eye tracking of gaze patterns.

Methods:

Participant eye movements were tracked (Tobii Pro) while viewing photographs of a profile face and close-up view of the ear. The tragus was absent in half of the images. Gaze patterns were visualized as heat maps, and t-tests compared areas of interest on the face and ear.

Results:

Fifty adults (27 female, ages 21–83) without medical training participated. While viewing a profile face for 10 s, participants looked at a normal ear for 2.19 s (1.5–2.9) (mean, 95% CI) and an ear without a tragus for 2.25 s (1.6–2.9) (p = 0.81). On close-up view, the tragus received the least attention (0.19 s, 0–0.19), while gaze at the canal increased from 0.82 s (0.39–1.3) to 1.39 s (0.96–1.8) when the tragus was absent (p = 0.02).

Conclusion:

When the tragus was absent, gaze patterns of the profile face were not impacted; however, the ear canal was more exposed and received more attention on close-up view of the ear. This may influence aesthetic goals in auricular reconstruction.