Evidence map›Paper›PMID 42050069›Full record

ArticleSleep & breathing = Schlaf & Atmung2026

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

Remzi Dogan, Yasin Kulaksiz, Alper Yeni̇gun, Ramazan Bahadır Kucuk, Ahmet Onur Sutcu, Selahattin Tugrul, Fadlullah Aksoy, Orhan Ozturan

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Article in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Remzi DoganFaculty of Medicine, Department of Otorhinolaryngology, Bezmialem Vakif University, Adnan Menderes Bulvari, Fatih, Istanbul, 34093, Turkey.
Yasin KulaksizDepartment of Otorhinolaryngology-Head and Neck Surgery, Medipol Acıbadem District Hospital, Istanbul Medipol University, Istanbul, Türkiye.
Alper Yeni̇gunFaculty of Medicine, Department of Otorhinolaryngology, Bezmialem Vakif University, Adnan Menderes Bulvari, Fatih, Istanbul, 34093, Turkey.
Ramazan Bahadır KucukFaculty of Medicine, Department of Otorhinolaryngology, Bezmialem Vakif University, Adnan Menderes Bulvari, Fatih, Istanbul, 34093, Turkey. r.bahadir_kucuk@hotmail.com.ORCID http://orcid.org/0000-0002-0925-6710
Ahmet Onur SutcuDepartment of Otorhinolaryngology-Head and Neck Surgery, Bingöl State Hospital, Bingöl, Türkiye.
Selahattin TugrulDepartment of Otorhinolaryngology-Head and Neck Surgery, Medipol Acıbadem District Hospital, Istanbul Medipol University, Istanbul, Türkiye.
Fadlullah AksoyFaculty of Medicine, Department of Otorhinolaryngology, Bezmialem Vakif University, Adnan Menderes Bulvari, Fatih, Istanbul, 34093, Turkey.
Orhan OzturanFaculty of Medicine, Department of Otorhinolaryngology, Bezmialem Vakif University, Adnan Menderes Bulvari, Fatih, Istanbul, 34093, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDiagonal 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. MATERIALS AND

methodsA 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.

resultsThere 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).

conclusionThe 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.

Indexed as

Sleep Apnea, ObstructiveAdultFemaleHumansMaleMiddle AgedPolysomnographyReference ValuesAuricular foldFrank signObstructive sleep apneaPolysomnography

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.