Defining the Prominent Ear: Anthropometric Profile of Prominent and Normal Ears in the Arabian Peninsula

Anthropometric measures enhance patient selection for surgical interventions and the diagnosis of congenital disorders.

To produce an objective definition of perceived ear prominence through a rigorous replication of Alexander (2011) anthropometric framework. The secondary objective is to characterize the anthropometry of normal and prominent Arabian ears.

A total of 350 ears of 175 volunteers were measured in the Frankfort horizontal plane. Twelve anthropometric measurements were obtained. Demographic information obtained included habitual earring wearing, ethnicity, and regional origin within Saudi Arabia. Perception of ear prominence status was recorded by the investigator and by a volunteer for each ear. Binary logistic regression, ROC curve, Youden index, left-right correlation, and one-way ANOVA were performed.

Logistic regression demonstrated increased odds of an ear being subjectively perceived as "prominent" with increasing helical-mastoid distance (HMD) and concho-mastoid angle (CMA), particularly among males and younger individuals. ROC curve and Youden index demonstrated that CMA had superior diagnostic accuracy (AUC=0.808) and an optimal cutoff of 60.50° (specificity=0.88) for the perception of ear prominence, while the HMD offered higher sensitivity (=0.84) at its optimal cutoff of 20.50 mm (AUC=0.760). Men had larger linear ear dimensions and CMA, while women had larger auricular-inclination angles and deeper conchae. Males had near-perfect symmetry, while women had natural mild asymmetry.

The authors objectively confirmed CMA and HMD as the most valid anthropometric measures of " perceived " prominence and introduced validated cutoffs. This replication establishes normative anthropometric auricular data for Arabian populations, verifies male-biased linear dimensions and increased symmetry, and emphasises female-specific ethnic variation.