A Validated Assessment Scale for the Auriculocephalic Angle in Asians

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Facial Anatomy

Background:

• The auriculocephalic angle significantly influences facial aesthetics, particularly in East Asian populations.
• Smaller angles can distort facial proportions, creating undesirable visual effects.
• Objective assessment tools for the auriculocephalic angle are currently limited.

Purpose of the Study:

• To develop and validate the Imeik Lying Ears Severity Scale (ILESS).
• To establish a standardized photonumeric scale for evaluating the auriculocephalic angle.

Main Methods:

• A database of 96 participants' photos was created using standardized 2D protocols.
• The ILESS scale (grades 0-4) was validated by 12 digital and 6 live expert evaluators.
• Inter- and intra-rater reliability were assessed using ICC and weighted Cohen's kappa.

Main Results:

• Digital validation demonstrated excellent inter-rater reliability (ICC: 0.90; kappa: 0.89-0.90).
• Live validation showed strong agreement (ICC: 0.82-0.85; kappa: 0.82-0.85).
• Intra-rater reliability consistently exceeded ICC and kappa values of 0.89, indicating high reproducibility.

Conclusions:

• The ILESS scale is a robust and versatile tool for standardized auriculocephalic angle assessment.
• Validation in digital and live settings confirms its clinical and research applicability.
• The ILESS scale advances aesthetic evaluation, treatment planning, and evidence-based aesthetic medicine.