A new clinical examination finding in obstructive sleep apnea; diagonal auricular fold (Frank sign)

Diagonal ear lobule fold (DELF)(Frank sign); It is a diagonal fold in the earlobe at an angle of about 45°, running diagonally from the tragus to the edge of the auricle at varying depths. In our study, the relationship between obstructive sleep apnea syndrome (OSAS) and DELF was examined.

A total of 132 patients, including 99 patients with sleep apnea complaints and 33 volunteers without complaints, were included in the study. Ear, nose and throat examination of the participants was performed and their ear lobules were examined. All participants underwent polysomnography. The patients were examined in four groups. Group 1 (AHI < 5)(Normal, n = 33), Group 2 (AHI = 5-15)(Mild, n = 33), Group 3 (AHI = 15-30)(Moderate OSAS, n = 33), Group 4 (AHI > 30)(Severe OSAS, n = 33). Demographic information of all participants was recorded.

There was no significant difference between the ages of the groups (43.48, 44.42, 48.69, 47.27, respectively) (p > 0.05). When evaluated in terms of BMI, group 1 was significantly lower than group 4 (p=0.002). There was no significant difference between the other groups (p > 0.05). There was no significant difference between the groups in terms of chronic diseases (CVO, CAD, HT, DM, COPD) (p > 0.05). DELF presence of groups; group 1: 0.59 ± 0.80, group 2: 0.57 ± 0.78. group 3: 0.80 ± 0.86, group 4: 1.10 ± 0.97. There was a significant increase in group 4 compared to group 1 and group 2 (p=0.004, p=0.006, respectively). There was no significant difference between the other groups (p > 0.05).

The presence of DELF (Frank sign) in patients with severe OSASwas demonstrated for the first time in this study. According to the results we have reached, DELF can be used as a new examination finding in the diagnosis of OSAS. We also think that it can be used as a marker in the clinical course of the disease.