ABSTRACT
BACKGROUND: The antitragicus is one of six intrinsic muscles of the external ear. This study examined the anatomical variations of the muscle and its association with prominent ears. METHODS: Twenty-seven consecutive patients presenting for correction of prominent ears were recruited into the study. In each case, the antihelical fold was assessed preoperatively by a single investigator. A standard anterior cartilage scoring otoplasty was performed, and the presence and quality of the antitragicus muscle were assessed by a second investigator. For statistical analysis, the qualitative assessment of the fold and the muscle was given a numerical value. It was then possible to plot the qualitative assessment of the fold against the muscle, and correlations between muscle and fold were calculated. RESULTS: The presence of the muscle was associated with an absent antihelical fold, whereas a well-defined antihelical fold was associated with an absent muscle (p < 0.0001). CONCLUSIONS: The authors propose that the presence of a well-formed antitragicus muscle, which exerts an anterior pull on the cauda helicis, contributes to the poor development of the antihelical fold.
