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Review
. 2012 Jan 1;17(1):e153-9.
doi: 10.4317/medoral.17390.

Diagonal ear lobe crease and atherosclerosis: a review of the medical literature and dental implications

Arthur H Friedlander  1 , José López-López, Eugenio Velasco-Ortega
Affiliations
Review

Diagonal ear lobe crease and atherosclerosis: a review of the medical literature and dental implications

Arthur H Friedlander et al. Med Oral Patol Oral Cir Bucal. .

Abstract

In Spain a significant number of individuals die from atherosclerotic disease of the coronary and carotid arteries without having classic risk factors and prodomal symptoms. The diagonal ear lobe crease (DELC) has been characterized in the medical literature as a surrogate marker which can identify high risk patients having occult atherosclerosis. This topic however has not been examined in either the medical or dental literature emanating from Spain. The majority of clinical, angiography and postmortem reports support the premise that DELC is a valuable extravascular physical sign able to distinguish some patients at risk of succumbing to atherosclerosis of the coronary arteries. A minority of studies have however failed to support this hypothesis. More recently reports using B mode ultrasound have also linked DELC to atherosclerosis of the carotid artery and another report has related DELC to the presence of calcified carotid artery atheromas on panoramic radiographs. DELC is readily visible during head and neck cancer screening examinations. In conjunction with the patient's medical history, vital signs, and panoramic radiograph, the DELC may assist in atherosclerotic risk.

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Figures

Figure 1
Figure 1
A 69 year old man with a very well defined diagonal ear lobe crease on the left side.
Figure 2
Figure 2
The same patient with a somewhat less distinct diagonal ear lobe crease on the right side.
Figure 3
Figure 3
A cropped panoramic radiograph of the same individual in Figures 1 and 2. Note the two calcified carotid artery atheroma superior to the prominent semi lunar shaped epiglottis and the letter “L” marker.
See this image and copyright information in PMC

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