Triangular Fossa Cartilage Graft in Rhinoplasty: A Three-Dimensional Anatomical and Technical Feasibility Study

Huang CJ, Yen CI, Chang CS, Chen HC, Yang SY, Chang SY, Hsiao YC.

What this paper says

Harvesting an extra piece of ear cartilage from the triangular fossa through the same incision as a conchal graft caused no significant change in ear height, width or bowl dimensions across 15 donor sites.

Overview

Rhinoplasty needs a stable framework, and conchal cartilage from the bowl of the ear is commonly used but often insufficient in volume, particularly in revision cases. The authors describe harvesting the triangular fossa cartilage at the same time, through the same incision behind the ear, to increase available graft material without creating another donor site.

Sections of note

Design: retrospective analysis of 14 patients, 15 ear donor sites, assessed with three dimensional imaging.
Three groups compared: conchal cartilage only; conchal plus triangular fossa without preserving the helix crux; and conchal plus triangular fossa with it preserved.
Three dimensional analysis showed no significant differences in ear height, width or conchal cavity dimensions.
A mild reduction in triangular fossa area was observed but produced no visible deformity or functional problem.
Preserving the helix crux maintained the natural curvature of the antihelix, keeping the donor site stable.
Stated application: cases needing additional cartilage, particularly revision rhinoplasty. The authors state longer follow up and patient reported outcomes are needed.

What it means for a patient

Running out of ear cartilage usually means moving to rib, which requires a chest incision, and this technique adds volume without that.
The ear kept its measured shape, with only the triangular fossa itself slightly reduced and not visibly so.
Preserving one specific ridge, the helix crux, was what kept the ear's curve intact, so the technique detail matters.
Limits: 14 patients, retrospective, no patient reported outcomes, and no data on how the harvested cartilage performed in the nose.

Why this paper matters

Graft supply is the practical constraint in revision rhinoplasty, and each additional donor site adds pain and scarring. Extending an existing harvest through the same incision is the least costly way to add material. Whether triangular fossa cartilage behaves like conchal cartilage once implanted is not addressed.

Terms

Concha: the bowl shaped hollow of the outer ear, a common cartilage donor site.
Triangular fossa: a small triangular hollow in the upper part of the outer ear.
Helix crux: the ridge where the ear's outer rim crosses into the conchal bowl.
Antihelix: the curved ridge inside the outer rim of the ear.
Autogenous graft: tissue taken from the patient's own body.
Donor site morbidity: pain, scarring or complications where tissue was harvested.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Aesthetic rhinoplasty relies on a stable framework for long-term structural integrity, often requiring autogenous cartilage grafts. While conchal cartilage is commonly used, its volume may be insufficient, particularly in secondary or revision rhinoplasty. This study presents a novel technique for simultaneous…”

Excerpt; the full abstract is on PubMed.