Can the Antitragus Grow?
Yes, the antitragus cartilage can grow during fetal development and early childhood, but this growth is largely complete by late-term fetal stages, with the antitragus being well-developed by near-term gestation.
Developmental Timeline of Antitragus Growth
The antitragus undergoes significant growth during specific developmental periods:
Midterm fetal development (15-16 weeks): The tragus and antitragus are not clearly identifiable as distinct structures, with the auricular cartilage existing as a single wavy plate 1
Near-term fetal development (29-40 weeks): The tragus-antitragus cartilages become well-developed structures that sandwich a deep notch of skin below the helix tail 1. The antitragus is added to the antero-inferior side of the cartilage plate during this period 1
Postnatal period: The antitragicus muscle (which arises from the outer part of the antitragus cartilage) continues to develop, though muscle establishment is markedly delayed compared to cartilage development 1
Clinical Significance of Antitragus Development
The antitragus and its associated muscle have important functional and aesthetic implications:
Overdevelopment or malpositioning of the antitragicus muscle can exert an anterior pull on the helical tail, causing prominent lobules 2
A well-formed antitragicus muscle is associated with poor development of the antihelical fold and contributes to prominent ear deformity (p < 0.0001) 3
The antitragicus muscle inserts into the helical tail and antihelix, and its presence correlates with absent antihelical folds 3
Surgical Reconstruction Context
In auricular reconstruction surgery, the antitragus can be artificially constructed:
The antitragus is fabricated by bending the antihelix and stabilizing it on a broadened base frame when using autologous costal cartilage 4
This cartilage-sparing technique has demonstrated effectiveness with an average aesthetic outcome score of 9.0 ± 0.7 in 658 patients 4
Key Clinical Pitfall
Do not confuse accessory tragus (a congenital malformation that can be associated with various syndromes including Goldenhar, Townes-Brocks, and Treacher-Collins syndromes) with normal antitragus growth 5. Accessory tragus represents a developmental defect rather than normal growth variation.