Morphometry of the adult human earlobe: a study of 547 subjects and clinical application

Morphometric Parameters of the Ear and Their Sexual Dimorphism in the Eastern Province of Saudi Arabia

Background The human ear is a distinctive facial feature, revealing valuable information about ethnicity, gender, and age. Anthropometric measures play a crucial role in fields such as forensic medicine, prosthetics, and plastic surgery. The external ear, known for its diversity in structure and individual characteristics, has become a subject of interest in various populations. This study aims to determine the mean values of morphometric measurements for both right and left ears while exploring sexual dimorphism in ear dimensions. Methodology A prospective, observational, cross-sectional study was conducted among 200 volunteers from the eastern province of Saudi Arabia, comprising 98 males and 102 females, at the Department of Anatomy, Institute of Medical Sciences, Imam Abdulrahman Bin Faisal University. Participants were randomly selected from King Fahad University Hospital workers and patients. Using a Vernier caliper and after obtaining consent, various aspects of ear morphology were measured. The study employed statistical analyses such as the volunteers' t-test, Pearson's coefficient of correlation, and linear regression equations. Results In males, the mean total height of the right and left ears was 6.054 ± 0.5394 and 6.044 ± 0.5235 cm, respectively, while for females, it was 5.489 ± 0.4481 and 5.763 ± 4.8446 cm, respectively. The mean widths, heights, and other dimensions of the ears exhibited variations between genders. Conclusions The study provides comprehensive insights into the dimensions and indices of the pinna among the population of the eastern province of Saudi Arabia. The findings confirmed the presence of sexual dimorphism in the ear measurements, consistent with observations in other ethnic groups.

Case series of keloid wedge resection in the ear: a focus on aesthetic aspects

Keloid scars may cause a range of symptoms and aesthetic problems. The ear is one of the most frequent sites of keloids, and the earlobe and ear helix account for more than 80% of ear keloids. There are various surgical methods for removing keloids in the ear. Standard keloidectomy and core excision can be effective surgical methods compared to wedge resection since they preserve normal tissue surrounding the keloid. However, ears often show various types of asymmetry by default, which can be relatively difficult to detect, so wedge resection continues to be a useful surgical method for ear keloids. Here, we report four cases of keloids in the earlobe and ear helix that were successfully treated by wedge resection without a postoperative deformity or recurrence.

Analysis of the auricles and auricular shape types for ear-related wearables: A study of mainland Chinese sample aged 15–79

BACKGROUND: Comprehension of the complex shape of the auricle and how it differs in terms of factors such as sex, age, and side have become an imperative aspect of the fabrication and service delivery of products that are natural, functional, and healthy for users. OBJECTIVE: This study was aimed at providing a clear understanding of the anthropometric characteristics based on age, sex, size, and side and shape type of the auricles of mainland Chinese samples. METHODS: Casting and 3D scanning were employed to obtain eighteen auricular measurement variables from 1120 subjects (aged 15–79). Examination of sex-related and bilateral differences were conducted. Furthermore, factor analysis was employed to establish the factors associated with the variations in auricular shape. Also, hierarchical cluster analysis was performed to classify the auricular shapes of individuals. RESULTS: The auricular inclination angle, conchal depth and tragal height did not exhibit any specific trend across the age groups. No significant bilateral difference was observed in both genders. The auricular shapes were classified into five types according to six major factors. CONCLUSIONS: It was observed that measurement variables of the Chinese auricles changed continuously with age, with most of the linear variables exhibiting a steady increase. The apparent strong association between the auricular types and age groups indicate that a person’s auricular shape may change with age.

Anthropometric assessment of human auricle in North Indian population

Introduction:

Morphometric studies of the auricle find its place in many areas, such as esthetics, forensic medicine, biology, anthropology, mythology, arts, and acupuncture.

Aims and Objective:

This study aims at establishing the anatomical variations in the auricular dimensions in North Indian population. The objectives of this study were to measure auricle height in males and females, to measure auricle width in both sexes, to measure lobular height (LH) in both sexes, to measure lobular width (LW) in both sexes, to calculate the auricle index in both sexes, and to calculate lobular index in both sexes.

Materials and Methods:

This study was conducted on 130 subjects (78 males and 52 females), in the age group of 18–25 years, without history of genetic disorders, injuries, or any disease of the auricle.

Results:

The average length of the auricle was 6.28 cm (right) and 6.23 cm (left), and the average width was 3.21 cm (right) and 3.28 cm (left). The average height of the lobule was 1.76 cm and 1.77 cm on the right and left sides, respectively, while the lobule width was 1.90 cm on the right side and 2.01 cm on the left side.

Conclusion:

Total right auricle height and total auricle width of both the right and left ears are more in males as compared to females, and the difference between both the sides was significant. Both right- and left-side LH and LW were higher in males as compared to females.

An anthropometric study of the external ear in the Thai population

Auricular dimensions are important data for the treatment of auricular deformities, either congenital or acquired. Many previous studies have shown that the auricular dimension varies among ethnic groups; however, there are currently no available data for the Thai population. The objective of this investigation was to provide normative values regarding the adult ear dimensions in Thailand. A total of 200 Thai volunteers between the ages of 18 and 70 years (80 men, 120 women) were enrolled in this study. We measured six dimensions, including the auricular, lobular, and conchal length and width and the auricular projection at the superaurale and tragal levels. Moreover, we calculated the auricular, lobular, and conchal indices. The selected dimensions of the external ears were shown as means ± standard deviations. These parameters were then compared between the right and left sides, men and women and participants aged ≥50 and <50 years. We found that men have a significantly larger and more projected ear than women do. The length of the entire auricles and the length of the earlobe were also significantly longer in the population ≥50 years than those <50 years. This study provides normative data of the external ear dimension and projection in the adult Thai population. These data can be used to reconstruct the ear and face more appropriately for Thai individuals.

Assessment of the Orbital and Auricular Asymmetry in Italian and Sudanese Children: A Three-Dimensional Study

The evaluation of the symmetry of orbital and ear soft tissues is important for aesthetic and reconstructive surgery. However, little information is available for these facial regions, especially in children. We analyzed the orbital and auricular symmetry in 418 Italian and 206 Sudanese subadult males divided into three age groups (8–11, 12–15, and 16–19 years old). Orbital and auricular height and width were measured for calculating fluctuating and directional asymmetry indices. Differences in asymmetry indices according to ethnicity and age group were assessed through the two-way ANOVA test (p < 0.01), while differences in the prevalence of right or left asymmetry according to ethnicity were assessed through the chi-square test. On average, directional asymmetry indices ranged from −2.1% to 1.1%, while fluctuating asymmetry indices ranged between 2.9% and 5.4%, corresponding to a small effect size and to 1.06–2.34 mm actual dimensions. Sudanese subjects showed a greater asymmetry for all the indices except for the fluctuating asymmetry of orbital height (p < 0.01). The directional asymmetry of auricular width increased with age. A prevalent right-side asymmetry was found for all the orbital indices (p < 0.001) in both populations, although significantly more prevalent in Sudanese individuals (over 83% for both measures), while auricular measures showed a prevalent left asymmetry exclusively in the Sudanese but with lower percentages. Aside from the limited effect size, the results proved the ethnic variability of asymmetry of orbital and auricle regions in children and suggest the need to collect more population data.

The ideal auricular protrusion - An interactive perceptual pilot study

PURPOSE

Excessive ear protrusion (prominauris) can negatively affect facial appearance. Because the concept of an ideal auriculocephalic angle is controversial, however, it is difficult to define when an obtrusive auricle requires surgical intervention. It is often assumed that angles exceeding 30° require corrective surgery. However, little is known about public perception of ear protrusion. This study aimed to assess perceptions of different degrees of auricular protrusion.

MATERIALS AND METHODS

We conducted an interactive panel survey. Male and female evaluators assessed digitally processed cloned images of a male and female model that depicted various ear protrusions ranging from 0° to 90°. Predictor variables were the sex of the evaluator, the sex of the clone and the extent of auricular protrusion. The outcome variable was the overall attractiveness of auricular appearance.

RESULTS

Forty-four evaluators (students of dental medicine, mean age 25.43 years) participated in the study: 22 women and 22 men. The study results revealed sexual dimorphism, with the attractiveness of corresponding male and female clones rated differently. Male evaluators favoured female ear positions that fitted closer to the head; preferred alignments for female clones were: 18° (Mean) ± 9.38° (SD), p = 0.006; for male clones: 30° ± 7.94°, p = 0.003. Ear protrusion starts to negatively affect aesthetic appearance for male evaluators at positions of 42° ± 4.87° (female clone) and 54° ± 8.22° (male clone), p = 0.001. The panel of evaluators agreed to perceive angles of 21-24° ± 8.10° (female clones), ± 8.33° (male clones), as the ideal degree of protrusion in both sexes (p = 0.158).

CONCLUSION

In this study, perception of ear appearance depended on the sex of both the evaluator and the clone being assessed. Obtrusive ears were more readily accepted in male faces than in female ones. Nevertheless, the overall panel perception shows a preference for rather close fitting, unobtrusive ear alignments. For planning of corrective ear surgery, a target angle of approximately 22° can be considered as a desirable result.

Restoration of the Age Elongated Auricular Lobe

BACKGROUND

The ears increase in all dimensions over the years (eg, length, helix diameter, lobe length), but the most obvious change is the elongation or ptosis of the lobe. Its correction should be considered a part of facial rejuvenation.

OBJECTIVES

The authors presented the surgical procedure they have been utilizing to correct elongated earlobes.

METHODS

The authors described a simple and effective procedure consisting of the curved resection of the excess tissue of the lobe at its lower end and its reconstruction through the utilization of 2 triangular flaps of skin, taken from the lateral surface of the lobe, rotated backwards, and sutured to the medial surface, leaving a zigzag hidden scar.

RESULTS

The authors have utilized this surgical procedure over the last 16 years to correct ptosis of the earlobe as well as some of its other alterations due to aging. The results obtained are presented as well as the classification that the authors have utilized to qualify their degree of ptosis.

CONCLUSIONS

This procedure has yielded excellent results, with imperceptible scars, and is therefore very pleasing to patients and surgeon alike.

LEVEL OF EVIDENCE: 4

ANTHROPOMETRY OF THE EXTERNAL EAR AMONG ADULT IJAWS IN BAYELSA STATE OF NIGERIA

Background. External ear measurement is of utmost importance in reconstructive surgeries. Objectives. The present study is aimed at ascertaining sexual dimorphism in external ear anthropometry and ear lobe attachments among adults Ijaws in Bayelsa, Nigeria. Methods. A total of 112 adults within the age range of 18-50 yrs, who met the inclusion criteria, were involved in the study. Four linear dimensions of the ear, which are ear length (EL), ear width (EW), lobular length (LL) and lobular width (LW), were measured for both genders. The lobular attachment for both ears for males and females were also examined and results recorded. These data were subjected to Student t-test, Chi-square test, and Pearson’s correlation using SPSS version 20.0. Results. The mean values for EL, EW, LL, and LW for the left auricle in the males and females were 58.14±0.60, 27.41±0.37, 14.47±0.27, 13.50±0.34 and 57.90±0.16, 27.45±0.65, 15.41±0.31, 13.43±0.38 respectively. However, for the right auricle in the males and females, the values were 58.40±0.45, 28.21±0.68, 14.32±0.31, 13.04±0.32, and 56.66±1.10, 27.51±0.65, 15.58±0.29, 13.28±0.34 respectively. The left and right lobular length were the only parameters that proved statistical significance (p<0.05) in females compare to males. Pearson’s correlations between right and left sides for each of the parameters were positive and significant. Chi-square analysis revealed no significant relationship (p>0.05) between earlobe attachments and gender. Conclusions. Sexual dimorphism was thus established in the Ijaw population as regards lobular length dimensions. It is believed that the results of this study would be very useful for ear morphology and reconstructive surgeries.

Retrospective study of immediate postoperative electron radiotherapy for therapy-resistant earlobe keloids

Keloid resection followed by adjuvant radiotherapy is the most efficacious treatment for keloids. However, for earlobe keloids, an optimal protocol for the total dose and fractions of adjuvant radiation has not yet been established. We retrospectively analyzed the efficacy and safety of immediate three-fraction electron radiotherapy after operation for resistant earlobe keloids. From 2011 to 2017, three-fraction electron radiotherapy with single dose of 5 Gy was given postoperatively to 23 patients with 30 keloids in our hospital. The first fraction of adjuvant radiotherapy was administered within 2 h of surgery, and the other two sessions were completed within the next day or two. Five (16.7%) primary keloids and 25 (83.3%) recurrent keloids were examined in this study. The primary endpoint was the local control rate, which was 86.7% after a median follow-up of 26 months (14–93 months). Secondary endpoints were acute and late procedure-related complications, and no severe complications were observed after combination therapy. Our results suggest that three-fraction electron radiotherapy after excision within 2 days of surgery is a safe and effective protocol for the prevention of earlobe keloid recurrence that can also improve patient compliance and comfort.

Dependency relationships among ear characters in a Spanish sample, its forensic interest

The aim of this paper is to provide information on dependency relationships between the morphological characters of the external ear and their importance in physical identification. At present, there is a lack of population data in this field, and little research has been published. Our study sample consisted of 281 Spanish university students of European descent aged between 18 and 31 years old. We analysed a total of 562 ears. For a large number of characters, we found a dependency between anatomically related characters, confirming our hypothesis. For example, we found relationships between ear shape and protrusion, between rolling of the superior and posterior helix, and between the upper and lower parts of the scapha. However, our results also indicated that some anatomically related characters did not present relationships. Thus, we found no dependency between contour shape of the supero-posterior helix and rolling of the posterior helix or between intertragic incisure shape and tragus or antitragus shape. In addition, we found that some characters that are not anatomically related also showed relationships. These included rolling of the superior helix and intertragic incisure shape, and contour shape of the superior helix and the inferior part of the scapha. These results are of great importance and should be taken into account in forensic applications.

Reevaluation of the earlobe types in Koreans

The shape of the earlobes has a variety of genetic significance. This study analyzed the frequencies of the earlobe shapes in the Korean population. Data were collected on randomly selected 500 males and 500 females in Daegu Metropolitan City, with all participant ages being in their twenties. Obtuse angled earlobes accounted for 41.2% of the earlobes observed, while acute angled earlobes prevalence was calculated at 38.8% and right angled earlobe was 20.0% of the total (sexes combined). In men, the acute angled earlobe was the most frequent type (43.0%), while the obtuse angled earlobe was the most frequent type in females (45.2%). These differences were statistically significant (p = 0.015). Overall, attached type earlobe (61.2%) was more frequent than free type earlobe. The attached type earlobe was more common in both sex groups (57.0% in male and 65.4% in female), and the proportion was significantly higher for females (p = 0.006). In conclusion, the findings in this study suggest that the attached earlobe type is the most common among Koreans, and the proportion of earlobe types among males and females is significantly different. Further studies are needed to understand the genetic background of earlobe types among Koreans.

Anthropometric Assessment of the Normal Adult Human Ear

PURPOSE

Knowledge of anthropometric measurements of the external ear is important as variations exist based on gender, age and ethnicity. This study has derived anthropometric data pertaining to the external ear in the Maharashtrian population.

MATERIALS AND METHODS

Nine variables of the external ear were measured in 505 Maharashtrian adults (aged 18-64 years) using photoanthropometric methods.

RESULTS

Descriptive data and the left-right symmetry for the study population were obtained.

CONCLUSION

These data have applications in screening for or monitoring diseases, otoplastic surgery, forensics, industrial design, apparel design and ergonomics.

Morphological variability of the earlobe in a Spanish population sample

This article shows the morphological variability of the earlobe in a Spanish population of European origin. The frequencies of four lobe characteristics (attachment, contour, modeling, and size) and their degree of expression were studied. The relationship among the characteristics and the differences involving sex and laterality were also considered. The least frequent morphology, and of main use in solving forensic cases, was the very small size with triangle-pulled contour into the skin and crossed-discontinuous modeling. The most frequent morphology, and most clinically useful, was the medium-sized lobe with free-arched contour and eminent or cross-continuous modeling. The characteristics were all symmetric. Size and modeling showed sexual dimorphism. Some characteristics were associated with each other: attachment with contour and modeling and the contour with modeling and size. The least frequent peculiarities were sharp lobe and virgule. The literature is scarce on this matter, practically non-existent for some characteristics, especially modeling and peculiarities. For the first time, the associations of the ear characteristics were analyzed, and this information could be applied to forensic identification.

Earlobe Reduction with Minimally Visible Scars: The Sub-Antitragal Groove Technique

BACKGROUND

Ptosis of the earlobe is a common consequence of ageing, defined as an unappealingly large free caudal segment of over 5 mm. It is therefore important to consider reduction as a complement to rhytidectomy in selected patients. Moreover, facelifting operations can result in disproportionate or poorly positioned earlobes. Current earlobe-reducing techniques can leave a scar on the free lateral edge causing notching or involve complex pattern excisions with limited resection capability and the risk of deformities. The presented technique, on the other hand, is versatile and easy to use, as it follows general geometric principles.

METHODS

Excision of the designed area results in an earlobe flap which can be rotated in the excision defect. This results in ideal scar locations, situated at the sub-antitragal groove and at the cheek junction. The technique is adjustable, to incorporate potential piercing holes.

RESULTS

This technique takes approximately 15 minutes per earlobe to complete. The resulting earlobes have undisturbed free borders. No vascularization-related flap problems were noted.

CONCLUSIONS

This technique is a viable method for reducing the earlobe with minimally visible scars.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Earlobe Rejuvenation: A Fat Grafting Technique

BACKGROUND

The earlobe demonstrates stereotypical signs of aging, including wrinkles and volume depletion.

OBJECTIVES

The purpose of this study is to review the outcome of the earlobe rejuvenation developed by the senior author.

METHODS

We describe our earlobe rejuvenation technique refined over 10 years that uses fat grafting to the earlobe. Three raters assessed preoperative and postoperative photographs of 40 earlobes in 20 patients. Each earlobe was evaluated for volume deficiency, number of deep creases, depth of creases, and number of fine wrinkles. Inter-rater reliability was calculated. Earlobe length was also measured.

RESULTS

Seventeen females and 3 males with average age of 63 years were followed for an average of 26 months. Postoperative improvements were observed in earlobe volume deficiency and number of fine wrinkles (P < .05). Improvements were seen in number and depth of creases and the earlobe height, but these were not significant (P > .05). No complications relating to the earlobe were observed in these patients.

CONCLUSIONS

Fat grafting can be an effective means for earlobe rejuvenation.

LEVEL OF EVIDENCE

4 Therapeutic.

Morphological Variations and Biometrics of Ear: An Aid to Personal Identification

INTRODUCTION

The morphological characteristics and dimensions of external ear vary in different human ethnic races which can be utilized in forensics for personal identification of living or deceased.

AIM

To determine uniqueness of morphological and biometric variations of both ears for individualization among North East (NE) and North West (NW) subpopulation of India.

MATERIALS AND METHODS

The study was conducted on randomly selected 80 students, 40 from each subgroup. Nine ear parameters were recorded twice using digital Vernier's caliper by single investigator and two indices (Ear Index and Lobule Index) were calculated for both the ears. Morphological ear shapes and lobule attachment were also noted. Pearson's coefficient correlation test was performed on cross-tabulations to evaluate significant relationship between different variables.

RESULTS

Of the total 35% free and 65% attached ear lobes were noted in both population groups. Oval ear shape was most commonly noted followed by triangular, rectangular and round in both populations. On comparing anthropometric measurements of ears in two populations it was found that except the tragus length and lobule index all other values were noted more in NW population. No statistical difference was found in ear and lobular indices of males and females although the left ear index and lobule index were found to be higher than right in both populations except in NW females where right lobule index was recorded more than left.

CONCLUSION

The results obtained can be used in anthropological and forensic sciences for the inclusion and exclusion of persons for identification on the basis of ear variations.

Ear Lobule Rejuvenation in Face-Lifting: The Role of Fat Augmentation

Supplemental Digital Content is available in the text.

Background:

Ear lobule ptosis and deflation are characteristics of facial aging. A rhytidectomy without rejuvenation of a deflated ear lobule may fail to address all aspects of facial aging. Fillers have been used to treat ear lobule deflation; however, autologous fat transfer has never been utilized for ear lobule rejuvenation. This investigation studies the success of autologous fat transfer to the ear lobule as part of volume augmentation rhytidectomy.

Methods:

A retrospective review of patients who underwent rhytidectomy between 2000 and 2014 by a single surgeon was performed. Patients between 2000 and 2004 who did not receive autologous fat transfer served as controls (group A). Patients between 2010 and 2014 who received autologous fat transfer to the ear lobule formed the treatment group (group B). Three independent observers reviewed preoperative and postoperative photographs for both groups at 1 year postoperatively. The following ear lobule volume grading scale was applied to numerically assess the patients: concave = 0, flat = 1, convex = 2, and round = 3.

Results:

Groups A and B each consisted of 65 consecutive patients (130 ears). In group A, the mean preoperative ear lobule grading score was 1.20, and the mean postoperative score was 1.22 (mean difference, 0.02; P = 0.42). In group B, the mean preoperative ear lobule grading score was 0.98, and the mean postoperative score was 2.00 (mean difference, 1.02; P < 0.0001).

Conclusion:

In patients receiving autologous fat transfer to the ear lobule during rhytidectomy, there was a significant change from a deflated ear lobule preoperatively to a more voluminous lobule at 1 year postoperatively.

A genome-wide association study identifies multiple loci for variation in human ear morphology

Here we report a genome-wide association study for non-pathological pinna morphology in over 5,000 Latin Americans. We find genome-wide significant association at seven genomic regions affecting: lobe size and attachment, folding of antihelix, helix rolling, ear protrusion and antitragus size (linear regression P values 2 × 10(-8) to 3 × 10(-14)). Four traits are associated with a functional variant in the Ectodysplasin A receptor (EDAR) gene, a key regulator of embryonic skin appendage development. We confirm expression of Edar in the developing mouse ear and that Edar-deficient mice have an abnormally shaped pinna. Two traits are associated with SNPs in a region overlapping the T-Box Protein 15 (TBX15) gene, a major determinant of mouse skeletal development. Strongest association in this region is observed for SNP rs17023457 located in an evolutionarily conserved binding site for the transcription factor Cartilage paired-class homeoprotein 1 (CART1), and we confirm that rs17023457 alters in vitro binding of CART1.

Estimation of sex from the anthropometric ear measurements of a Sudanese population

The external ear and its prints have multifaceted roles in medico-legal practice, e.g., identification and facial reconstruction. Furthermore, its norms are essential in the diagnosis of congenital anomalies and the design of hearing aids. Body part dimensions vary in different ethnic groups, so the most accurate statistical estimations of biological attributes are developed using population-specific standards. Sudan lacks comprehensive data about ear norms; moreover, there is a universal rarity in assessing the possibility of sex estimation from ear dimensions using robust statistical techniques. Therefore, this study attempts to establish data for normal adult Sudanese Arabs, assessing the existence of asymmetry and developing a population-specific equation for sex estimation. The study sample comprised 200 healthy Sudanese Arab volunteers (100 males and 100 females) in the age range of 18-30years. The physiognomic ear length and width, lobule length and width, and conchal length and width measurements were obtained by direct anthropometry, using a digital sliding caliper. Moreover, indices and asymmetry were assessed. Data were analyzed using basic descriptive statistics and discriminant function analyses employing jackknife validations of classification results. All linear dimensions used were sexually dimorphic except lobular lengths. Some of the variables and indices show asymmetry. Ear dimensions showed cross-validated sex classification accuracy ranging between 60.5% and 72%. Hence, the ear measurements cannot be used as an effective tool in the estimation of sex. However, in the absence of other more reliable means, it still can be considered a supportive trait in sex estimation. Further, asymmetry should be considered in identification from the ear measurements.

Aesthetic earlobe remodeling: my personal experience with an LBO laser at 532 nm

Since 1960, when Maiman built the first laser equipment, this technology has gone through a continuous development and an increasing utilization in several fields. Nowadays many pathologies find a less traumatic solution in laser technology. Laser can be either used to treat lesions with a high bleeding risk such as hemangioma and lymphangioma or in patients with coagulation diseases or hypertension, taking advantage of its capability to coagulate. Moreover healing and scarring are improved by the laser's effect of biostimulation and inhibition of bacterial growth, this leading to a greater comfort for the patient. The tissue vaporization and the dimension of the damaged area depend on several factors, those related to the laser used, such as wavelength, power, emission mode (continued or pulsed mode) and the power density, and those concerning to the treated tissue, like color and consistency. In this Study, we used an Lithium Borate, (LBO), laser, instead of scalpel for earlobe reduction in a 35-year-old male patient with pending lobule. LBO laser works through a solid active medium emitting a visible green light. A diode laser, with a wavelength of 810 nm, stimulates a crystal of Nd:YAG, which has a wavelength of 1064 nm. Then a crystal of LBO doubles the vibration frequency of the photons, leading to a final wavelength of 532 nm.

Age- and sex-related changes in the normal human ear

The objective of this study was to supply information about: (1) normal sex-related dimensions of ears (linear distances and ratios, area); (2) left-right symmetry; and (3) growth changes between childhood and old age. The three-dimensional coordinates of several soft-tissue landmarks on the ears and face were obtained by a non-invasive, computerized electromagnetic digitizer in 497 male and 346 female healthy subjects aged 4-73 years. From the landmarks, paired ear width and length, the relevant ratios, ear areas and angles relative to the facial midline, as well as indices of left-right symmetry, were calculated, and averaged for age and sex. Comparisons were performed by factorial analysis of variance. All ear dimensions were significantly larger in men than in women (p<0.001). A significant effect of age was found (p<0.001), with larger values in older individuals. The ear width-to-length ratio and the sagittal angle of the auricle significantly decreased as a function of age (p<0.001) but without sex-related differences. On average, the three-dimensional position of ears was symmetric, with symmetry coefficients ranging between 92% and 96%. Asymmetry was found in the sagittal angle of the auricle (both sexes), in the ear width-to-length ratio and ear width (men only). Data collected in the present investigation could serve as a data base for the quantitative description of human ear morphology and position during normal growth, development and aging. Forensic applications (evaluations of traumas, craniofacial alterations, teratogenic-induced conditions, facial reconstruction, aging of living and dead persons, personal identification) may also benefit from age- and sex-based data banks.

Anthropometry of the normal human auricle: a study of adult Indian men

BACKGROUND

To treat auricular deformities or to perform facial rejuvenation, a plastic surgeon requires normative data for auricular dimensions. The metric standards vary in various ethnic groups, and such data are especially scarce from in India. This study aimed to provide anthropometric information about the normal dimensions of the adult male auricle in central India.

METHODS

A cross-sectional study was undertaken in central India with 415 males categorized in five age groups. Six linear dimensions including the length and width of the auricle, lobule, and concha and the heights of the auricular protrusion at the superaurale and tragal levels were measured. Auricular, lobular, and conchal indices were calculated. The inclination of the auricle relative to its vertical axis was measured. Descriptions of various auricle parts including its shape, preauricular area, form of the helical fold, lobular shape, size, and type of attachment to the cheek were recorded.

RESULTS

Almost all the linear measurements showed a steady increase in size with age. The dimensions of the lobule were dependent on its shape and attachment to the cheek. The mean lobular and auricular indices were found to decrease with increasing age, indicating more elongation than widening of the structures. On the average, bilateral asymmetry was observed in all measurements, although only auricular length, width, and conchal length in a few age groups were found to be statistically significant. The frequency distribution of forms of various auricular features is presented.

CONCLUSION

The human ear continues to grow throughout life. The lobule contributes the most to the overall elongation of the auricle. This study furnishes the first set of metric data of auricular dimensions for normal Indian males 18 to 70 years of age. In comparison with other ethnic groups, Indian males seem to have the smallest auricular and lobular lengths, although their respective widths are comparable with those of others.

Morphometric study of ear lobule in northwest Indian male subjects

A total of 260 male subjects between 1 and 80 years of age of north-west region of India were studied with regard to morphometry of the ear lobule. The purpose of the present study was to obtain average values and range of measurements of several parameters of the ear lobule and the differences between right and left lobules. Female subjects were excluded from the study due to piercing. Various measurements of lobule were taken with the help of Vernier and Lange's calipers. The results of the aforementioned measurements were analyzed statistically using Student's t-test. The maximum length of the lobule increased appreciably between 6-15 years and 41-80 years. The breadth of the ear lobule increased up to the age of 15 years and was almost static between the ages of 16 and 40 years and increased again from 41 years onwards. Length of the lobule showed significant growth from the age group of 6-10 to 11-15, 21-40 to 41-60 and 41-60 to 61-80 years on the right side and 6-10 to 11-15 and 21-40 to 41-60 years on the left side. Breadth and thickness of ear lobule also showed statistically significant growth pattern in some age groups. On comparing the ear lobe dimensions with the studies available in other populations of the world, it was observed that north-west Indians have smaller ear lobules as compared to Caucasian and Japanese populations. In the present study, the frequency of attached (square) type of lobules was the maximum, followed by free (pendulous) type and tapering lobules. These findings were similar to those found among the Onge tribe of Andhra (India) and Newars of Nepal.

Morphometry of the external ear in our adult population

This study aimed to determine the mean values of the different morphometric measurements from right and left ears. These measurements were taken from 341 healthy young adults (150 women and 191 men) ages 18 to 25 years using an electronic digital caliper. The results showed the mean values for total ear height, lobular height and width, distances from tragus to antihelix and to helix, and ear projection and width to be, respectively, 59.7 +/- 3 mm, 17.5 +/- 1.4 mm, 18.5 +/- 2.2 mm, 16.6 +/- 1.7 mm, 25.1 +/- 2 mm, 16.6 +/- 2 mm, and 31.3 +/- 2.2 mm for the left ear, and 59.5 +/- 3.1 mm, 17.9 +/- 1.5 mm, 18.9 +/- 2 mm, 16.5 +/- 1.8 mm, 25.2 +/- 1.9 mm, 17 +/- 1.9 mm, and 31.2 +/- 2.2 mm for the right ear in the young women. However, in the young men, these values were, respectively, 63.1 +/- 3.6 mm, 18.3 +/- 1.7 mm, 19.4 +/- 2 mm, 17.2 +/- 1.8 mm, 26.3 +/- 1.9 mm, 17 +/- 2.3 mm, and 33.3 +/- 2.2 mm for the left ear, and 62.9 +/- 3.5 mm, 18.4 +/- 1.7 mm, 19.8 +/- 1.9 mm, 17.2 +/- 1.8 mm, 26.6 +/- 1.9 mm, 17.6 +/- 2.1 mm, and 33.1 +/- 2.1 mm for the right ear.

Morphometry of the ear in Down's syndrome subjects

The three-dimensional coordinates of 13 soft-tissue landmarks on the ears were obtained by a computerized digitizer in 28 subjects with Down's syndrome aged 12-45 years, and in 449 sex, age and ethnic group matched controls. From the landmarks, left and right linear distances (ear width and length), ratios (ear width-to-ear length), areas (ear area), angles (angle of the auricle versus the facial midplane) and the three-dimensional symmetry index were calculated. For both males and females, all linear dimensions and areas were significantly (Analysis of Variance, P < 0.001) larger in the reference subjects than in the subjects with Down's syndrome. All values significantly increased as a function of age (P < 0.05); the increment was larger in the reference subjects than in the subjects with Down's syndrome. On both sides of the face, the subjects with Down's syndrome had larger ear width-to-ear length ratios, and larger angles of the auricle versus the facial midplane than the reference subjects. The three-dimensional symmetry index was significantly larger in the reference subjects and in the older persons. In conclusion, ear dimensions, position and shape significantly differed in subjects with Down's syndrome when compared to sex, age and ethnic group matched controls. Some of the differences were sex and age related.

Nasal dimensions in normal subjects: conventional anthropometry versus computerized anthropometry

The aim of the current investigation was to compare computerized measurements of nasal linear distances (nasal tip protrusion, height of the cutaneous upper lip, length of the nasal bridge) collected from 705 healthy individuals from Northern Italy (age range 6-60 years) using an electromagnetic digitizer with conventional anthropometric measurements: one set obtained on individuals of central European origin (Zankl et al.), and one set collected from North American Caucasians (Farkas et al.). On average, the present lengths of the nasal bridge were always significantly smaller than the European data (P < 0.01, Student's t for independent samples). Nevertheless, only in one sex and age group of 18 the discrepancy between the two mean values was larger than 10 mm. In other 10 groups, the mean values differed less than 5 mm. More limited differences (up to 6.5 mm) were found in comparison to the American data. For nasal tip protrusion, digital and conventional data were significantly different (up to 4 mm) in 18 instances of 30. On average, the present heights of the cutaneous upper lip were always smaller than the European data (up to 2.9 mm). The differences were statistically significant in 14 groups of 18. Minor discrepancies (less than 1 mm in nine groups of 12) were found in comparison to the American data. Statistical significance was reached only in seven comparisons. In conclusion, the conventional anthropometric and the digital data compared in the current study, though not superimposable, seemed sufficiently interchangeable, at least from a clinical point of view.