title: Diagnosis and Prevalence of Prominent Lobules in Otoplasty: Analysis of 120 Patients with Prominent Ears.
abstract: BACKGROUND
  The prominence of the ear lobule is considered an anomaly of secondary importance and receives correspondingly less attention in literature. We reviewed a case series of otoplasty patients and analyzed the prevalence of lobule prominence.
  
  
  METHODS
  Records of otoplasties between 2007 and 2013 were reviewed. Inclusion criteria were: (1) primary otoplasties; (2) prominence of both ears; and (3) otoplasties conducted by the main author. Patients were divided into two groups: (1) A general group (GG) containing all the patients, and (2) a lobule correction group (LG)-a subgroup of GG containing only the patients who needed lobule correction.
  
  
  RESULTS
  From a total of 291 patients, 120 patients were included in GG and 27 patients in LG. There was no statistical difference between groups GG and LG in terms of age and gender. Preoperative diagnosis of lobule prominence was correctly established in 14 patients; 13 patients were diagnosed during surgery.
  
  
  CONCLUSIONS
  Lobule prominence should not be underestimated since its diagnosis may be missed in the preoperative period-nearly 50 % in our case. Also its prevalence (22.5 %) is not as infrequent as some may think. Knowledge of lobule correction techniques before surgery is important to avoid less than optimal results in otoplasty.
  
  
  METHODS
  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.
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil. lfungarelli@hotmail.com.
authors.forename: Luís Fernando
authors.initials: LF
authors.lastname: Ungarelli
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: Camila Zirlis Naif
authors.initials: CZ
authors.lastname: de Andrade
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: Evelyne Gabriela Schmaltz Chaves
authors.initials: EG
authors.lastname: Marques
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: João Luís Gil
authors.initials: JL
authors.lastname: Jorge
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: Bruno Francisco Müller
authors.initials: BF
authors.lastname: Neto
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: Guilherme Augusto Magalhães
authors.initials: GA
authors.lastname: de Andrade
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: Renan Victor Kumpel Schmidt
authors.initials: RV
authors.lastname: Lima
authors.affiliation: Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Altacílio Aparecido
authors.initials: AA
authors.lastname: Nunes
authors.affiliation: Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Avenida Norma Valerio Correa, 571 Casa 85, Ribeirão Preto, SP, 14021-593, Brazil.
authors.forename: Jayme Adriano
authors.initials: JA
authors.lastname: Farina
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000601:surgery; D003430:Cross-Sectional Studies; D054644:Ear Auricle / Q000002:abnormalities / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D013518:Surgery, Plastic / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Lobule prominence; Otoplasty; Pinnaplasty; Prominent ears