CE: D.C.

; SCS-21-0905; Total nos of Pages: 8;

SCS-21-0905

CLINICAL STUDY

Characteristic Features of Ear and Ear-Prints in

Forensic Identification
AQ1 Deepika Rani, MSc, PhD, Kewal Krishan, PhD, FRAI, Ramesh Sahani, PhD,
AQ2 Rijen Shrestha, MSc, PhD,y and Tanuj Kanchan, MDz

Introduction and Objectives: The human external ear is a
morphologically perplexing structure with wide variations in its
features across individuals. Advances in forensic science have
established the use of morphological features and prints of different
parts of the human body in establishing the identity of an individual.
The present study aims to establish such an identification process by
examining the use of comparative analysis of ear prints and ear
photographs.
Methodology: The study examined the morphological features of
ear prints of 140 participants (71 males and 69 females) ranging in age
from 18 to 25 years (with a mean age of 20.22  1.77 years), recruited
from a North Indian population. Prints of both the ears were recorded,
using the inking method. The morphological features of the ear prints
From the Department of Anthropology (UGC Centre of Advanced Study),
AQ3 Panjab University, Chandigarh, India; yDepartment of Forensic Medi-
cine, Maharajgunj Medical Campus, Tribhuvan Institute of Medicine,
Kathmandu, Nepal; and zDepartment of Forensic Medicine and Toxi-
cology, All India Institute of Medical Sciences, Jodhpur, India.
Received May 12, 2021.
Accepted for publication July 13, 2021.
Address correspondence and reprint requests to Kewal Krishan, PhD,
FRAI, Department of Anthropology (UGC Centre of Advanced Study),
AQ4 Panjab University, Sector-14, Chandigarh, India;
E-mail: gargkk@yahoo.com, kewalkrishan@pu.ac.in
Deepika Rani MSc PhD Research Scholar, https://orcid.org/0000-0003-

1924-3347); Kewal Krishan1 , Ph.D. (Associate Professor), (https://
orcid.org/0000-0001-5321-0958); Ramesh Sahani1, Ph.D. (Assistant
Professor); Rijen Shrestha1,2 M.Sc. (Ph.D. Research Scholar), (https://
orcid.org/0000-0002-8562-7712); Tanuj Kanchan3, MD (Additional Pro-
fessor), (https://orcid.org/0000-0003-0346-1075)
This study is a part of a Master’s Degree dissertation submitted to the
Department of Anthropology, Panjab University, Chandigarh, India by 1
of the authors (DR).
The authors (DR, KK, RS, RS) are supported by the UGC Centre of
Advanced Study in Anthropology (CAS II), Department of Science
and Technology-Promotion of University Research and Scientific Excel-
lence Grant (DST PURSE Grant) awarded to the Department of Anthro-
pology, Panjab University, Chandigarh, India. The nature of the research
work was explained to the participants and written consent was obtained
from each participant before initiating the study. All the authors have
given their consent for publication of this article and approved the final
version of the manuscript
The study is a part of a Master’s project and the raw data is available with 1 of
the authors (DR) who has been nominated as a guarantor for the work.
DR accepts full responsibility for the work and/or the conduct of the
study, had access to the data, and controlled the decision to publish.
AQ5 The authors report no conflicts of interest.
Supplemental digital contents are available for this article. Direct URL
citations appear in the printed text and are provided in the HTML and
PDF versions of this article on the journal’s web site (www.jcraniofa-
cialsurgery.com).
Copyright # 2021 by Mutaz B. Habal, MD
ISSN: 1049-2275
DOI: 10.1097/SCS.0000000000008056
were compared with the photographs of the ear for their uniqueness
and individualization using likelihood ratios.
Results: The degree of antihelix curvature demonstrated the highest
correlation (98.57%) between the morphological features visible on
the ear and the expressions of these features in an ear print. The
impression of earlobes, Darwin tubercle, crus of the helix, and shape
of the external ear showed accuracy between 70% and 90%,
whereas correlations below 70% accuracy were recorded for the
other features. The likelihood ratios for 12 parameters were reported
to be more than 10, representing that the identification made
using these parameters was > 10 times more likely to be true
identification as compared to false positives. Moreover, 5
parameters were found to show high sensitivity, with values
greater than 3 standard deviations (0.997), with an additional 9
parameters found to have good sensitivity at values greater than 2
standard deviations (<0.95). Similarly, 2 parameters were found to
show high specificity, with values greater than 3 standard deviations
(0.997), with an additional 18 parameters found to have good
sensitivity at values greater than 2 standard deviations (<0.95).
Conclusions: Elevated features of the ear, such as helix, antihelix,
antitragus, tragus, and inter-tragic notch; particularly the degree of
antihelix curvature, are more easily impressed and identifiable on an
ear print. The results support that ear prints may provide important
clues to assist in establishing the identity of an individual if several
morphological features are evaluated concurrently.
Key Words: Anatomy, congenital abnormalities and ear surgery,
criminalistics, ear morphology, ear photographs, ear prints,
identification, likelihood ratios
(J Craniofac Surg 2021;00: 00–00)
F orensic comparative studies examine characteristic traits that are
unique or individualistic to establish the identity of an individ-
ual. These remarkable characteristics in humans include finger-
prints,1,2 footprints,3–5 morphological facial features,6– 8 voice,9,10
iris,11,12 lip prints,13,14 palatal rugae,15,16 etc. The human external
ear also exhibits variations in the morphological features that may
be considered to be individualistic traits of an individual. These
morphological features include the helix, antihelix, Darwin tuber-
cle, earlobe, tragus, antitragus, etc.17,18 Additionally, the skin of the
external ear is smeared with secretions from the sebaceous glands,
dust, wax, creams, and other substances, which when pressed
against a surface, leave a two-dimensional representation of the
external ear, known as an ear print.19
Ear print impressions can be found in numerous cases of
medicolegal and criminalistic importance such as burglary, rob-
bery, theft, murder, rape, etc.20 In cases of burglary, theft, etc the
burglars may ‘‘spy’’ on a proposed location by listening in, by
pressing the ears against the doors and windows, to monitor for AQ6
noise and ascertain if anybody is inside or not. Consequently, ear

The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2021 1
CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905
Rani et al The Journal of Craniofacial Surgery
prints may be found on doors and windows at the crime scene in
addition to the other prints.19 This was established in a Polish
study,20 where ear prints were generally recovered from the win-
dows and doors of the houses. During the investigation of a crime
scene, the scene of crime officers can collect ear prints using
methods already in use for collecting latent fingerprints.20,21
The gathered ear prints can then be compared with ear prints
taken under controlled conditions, from the suspects. These corre-
lations can then help develop biological profiles of suspects, as well
as to eliminate the innocent individuals. In addition to the positive
identification of the suspect(s) using individualistic features, ear
prints may also help in the identification process by deciphering the
biological profile, including age, sex, and stature.
The ears are a significant landmark of the face and provide
valuable information for identification. Lateral photographs of the
face as well as partial photographs that are captured in closed-circuit
television images, especially where the suspect covers or obscures
the face, can be compared with the prints and photographs of the
ears of known offenders to assist the forensic investigation.
The human external ear has been the focus of numerous inves-
tigations since Darwin times; however, studies related to ear prints
are relatively recent, having started in the mid-twentieth century in
Switzerland, UK, and the USA. Numerous perpetrators have
already been convicted, based on the ear print evidence recovered
from the crime scene.22,23 However, the accuracy of the ear print
evidence has been questioned in the court of law and the appellant
court discredited the evidence in many convicted cases.24– 26 The
landmark case in the UK, in 1998, convicted Mark Dallagher in the
murder of Dorothy Wood, based on forensic comparison of ear
prints. The verdict was revised on 22 January 2004, 7 years after
AQ7 the conviction, with DNA analysis conclusively vindicating the
accused of the crime.27,28
Since then, various authors have focused on studies examining
the reliability and standardization of the ear print evidence. This
prompted the development of the forensic ear identification project
in 2005, and the development of a standardized procedure for ear
print collection, classification, and matching.29 Although the pro-
cess of matching ear prints with suspects may seem to be a simple
procedure, it is important to remember that the position of the
landmarks of the ears is altered when an ear is pressed against a hard
surface, as in the case of listening through a door or a window. This
has been confirmed by numerous studies that analyzed the effects of
pressure on the ear print.17,18,30–35
The Innocence Project has undertaken numerous appeals of
convictions based on comparative techniques and invalidated the
findings of numerous instances of hair analysis and odontological
analysis, using DNA analysis.36 This has increased scrutiny on the use
of the scientific basis of comparative sciences as evidence in criminal
cases.37 Similarly, the report furnished by the President’s Council of
Advisors on Science and Technology assessed the accuracy and
reliability of numerous comparative sciences and recommended
the need to further develop the scientific basis for these disciplines.38
Therefore, it is the responsibility of forensic researchers to ensure the
accuracy and reliability of the scientific techniques being used and
their validity. To this end, the present research uses the likelihood
ratio approach to provide a scientific and statistical basis to examine
the accuracy and reliability of ear prints.
The present study was conducted to examine the uniqueness and
variations present in the ear impressions in a North-Indian popula-
tion for their possible usefulness in identifying suspects from ear
prints encountered at the scene of the crime. The study endeavored
to conduct a comparative analysis of the individualistic features of
the ear prints of the participants with the photographs of their ears,
using likelihood ratios in the identification process. It attempts to
study the correlation of the expression of the features in the ear print
2 #
 Volume 00, Number 00, Month 2021
with the morphology of the same features on the external ear and
also investigates the likelihood ratios of the morphological features
present on the ear and the expression of these morphological
features in the ear print.
MATERIALS AND METHODOLOGY
Participants
The present study examines ear prints obtained from 140
participants (71 males and 69 females) from Nahan city, District
Sirmaur, Himachal Pradesh state of North India. The manuscript is
part of a large study conducted in the Department of Anthropology,
Panjab University, Chandigarh, India.39,40 Age of the subjects
ranged from 18 to 25 years with a mean age of 20.22  1.77 years.
years. The objective of the research was explained to the partici-
pants and their written consent was obtained before collecting the
ear prints.
The Material Used for Taking Ear Prints
Ear print of each subject was recorded with the inking method,
using Kores duplicating blank ink (manufactured by Indart materials
Private Limited, L-70, Verna Industrial Estate, Verna, Goa, India).
The other materials used in the study include a quarter-sized ink plate,
an inking pad, A-4 size paper sheets, and cardboard. The inking pad
was specially prepared with muslin cloth filled with cotton. The
muslin cloth is commonly used in making ink pads because of its
advantage over the other fabrics. It has large pores that provide a good
absorption capacity as compared to the other material.
The Methodology of Taking the Ear Prints
Before taking the ear prints, all of the subjects were instructed to
remove their earrings. For obtaining the ear prints, an ink pad was
prepared by applying ink over a muslin cloth and ensuring that the ink
was completely and equally spread on the cloth. Then the ink was
applied to the external ear, by dabbing the inked cloth on it, repeatedly
until the whole ear was smeared with ink. The subject was asked to sit
straight on a stool with his/her arms hanging down and a template was
prepared by fixing an A-4 sheet on a clipboard. The ear print was then
collected by the investigator who held the template in her hands and
directed the subject to press his/her ear against that template with
minimal pressure for 5 seconds. Although the simple technique used
did not confirm if the subjects were listening, the period of pressure
was kept constant and special consideration was also given to the
pressure applied for taking the print.
Analysis of the Ear Prints
The morphological features of the external ear were initially
noticed in the ear prints as well as from the photograph of the same
ear. The data was then entered into a Microsoft Excel spreadsheet
(2007). The number of matches between the ear print and the ear
photograph was then counted, and the percentage matching was
computed using the formula below.
Number of matched cases
Percentagematch ¼  100
Total number of cases
Further, for the analysis of the likelihood ratio, the true positive,
true negative, false positive, and false negative were calculated by
using the following definitions.
True Positive
When a test (for the existence of a certain feature) gives a
positive result (meaning the feature is present in the ear print) and
the person has that feature.
2021 Mutaz B. Habal, MD
CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905

The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2021 Characteristic Features of Ear

Now let us assume we want to see if the external ear has a

triangular shape. The test yields a positive result, indicating that the
triangular shape is observed in the ear print as well as in the
photograph. It will then be classified as a true positive.

True Negative
When a test (for the presence of a certain feature) yields a
negative result (meaning the feature is not evident in the ear print)
and the person does not have that feature.
Suppose that we want to test if the external ear is triangular in
shape. The test gives a negative result, signifying that the triangular
shape is not visible in both the ear print and the photograph. It will
then be considered as a true negative.

False Positive FIGURE 1. Variations of different parts in ear impression (A) to (N). AQ10
When a test (for the prevalence of a certain feature) returns a
positive result (meaning the feature is observed in the ear print), but
the person does not have that feature.
Assume that we want to test whether the external ear has a
triangular shape. The test produces a positive result, suggesting that
the triangular shape is apparent in the ear print but not in the
photograph. It will then be regarded as a false positive.

False Negative
When a test (for the occurrence of a certain feature) produces a
negative result (meaning the feature is not seen in the ear print), but
the person has that feature.
Imagine that we want to see if the external ear has a triangular
shape. The test returns a negative result, implying that the triangular
shape is not present in the ear print but is visible in the photograph.
It will then be considered as a false negative. FIGURE 2. Typical features of external ear which leave the impressions.
After calculating the true positive, true negative, false positive,
and false negative values, the sensitivity and specificity were
evaluated by using the formulae given by Chu41 and Simel et al.42 After observing the ear impressions, it was established that every
Number of True positive cases ear print is unique and individualistic in the features expressed. The
Sensitivity ¼
Number of True positive cases þ Number of False negative cases overall ear shape can also be identified from the prints as illustrated
in Figure 4. Different shapes were documented in the present
Specificity ¼
Number of True negative cases population, including oval, round, rectangular, and triangular,
Number of True negative cases þ Number of False positive cases which were visible in the ear prints (Fig. 4 A-D). The expression
of each feature is described below in detail and has been illustrated
The values of specificity and sensitivity were further used to
in Figure 5 A-G. The expression of unique features is exemplified
determine the positive likelihood ratio by using the following
from Figure 6 A-H. All these features were taken into consideration,
formula.
whereas observing ear prints.
Sensitivity Supplementary Digital Content, Table 1, http://links.lww.com/
Positive likelihood ratio ¼
ð1  SpecificiyÞ SCS/D95 depicts the percentage match between the morphological
features of the ear and the expressions of these features as compared
The sensitivity and specificity are classified as high at values to the ear photograph. The strength of antihelix curvature was
greater than 3 standard deviations (>0.997), whereas it is classified expressed in 98.57% of ear prints, whereas the impression of
as good at values greater than 2 standard deviations (>0.95). The earlobes, Darwin tubercle, crus of the helix, and shape of the
categorization of the likelihood ratio was taken as described by external ear were expressed in 70% to 90% of all ear prints. In
Simel et al.42

RESULTS
The ear print is a two-dimensional representation of the external ear.
Therefore, the morphological features leave their impression in the
form of ear print. These features can be easily demonstrated after
comparing the ear print and the ear photograph from the same
individual (Fig. 1). Figure 2 provides a diagrammatic representation
of the frequently observable features in an ear print. Impressions of
helix, antihelix, tragus, and antitragus, were the most common
features expressed in an ear print. In an ear print, the impressions of
morphological features of the ear show variations in their position,
angle, elevation, and depression; this has been established in FIGURE 3. Ear print and ear photograph of the same individual: (A) left and (B)
Figure 3. right.

# 2021 Mutaz B. Habal, MD 3

CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905
Rani et al The Journal of Craniofacial Surgery
FIGURE 4. Different shapes of the ear expressed in ear print: (A) round, (B) oval,
(C) triangular, and (D) rectangular.
contrast, inter-tragic notch, superior antihelix curvature, and
tragus were found to be present in only 50% to 70% of ear prints.
Lastly, 3 features, antitragus, type of connection between antihelix
and helix as well as the type of connection between antihelix
and antitragus were seen to be imprinted in less than 50% of ear
prints.
Following this, the sensitivity, specificity, and likelihood ratios
were calculated and are depicted in Supplementary Digital Content,
Table 2, http://links.lww.com/SCS/D95. The positive likelihood
ratio was found to be more than 10 folds for 12 parameters, namely,
triangular shape of right ear, rectangular shape of the left ear, slight
strength of the antitragus of right ear, no impression of earlobe of
both ears, impressions of anterior Darwin tubercle of both ears, the
impression of superior Darwin tubercle of left ear, impressions of
Darwin tubercle at the outer border of both ears and impressions of
Darwin tubercle at both the inner as well as the outer borders of both
ears. This means that the identification made using these 12
parameters was > 10 times likely to be true as compared to false
positive.
At values greater than 3 standard deviations (>0.997), ear prints
were found to be highly sensitive for 5 parameters that is, rectan-
gular shape of both ears, impressions of anterior Darwin tubercle of
both ears, and impression of superior Darwin tubercle of the left ear.
Meanwhile, only 2 parameters that is, rectangular shape of the
left ear and slight strength of antitragus of the right ear showed
high specificity. Besides, at values greater than 2 standard devia-
tions (>0.95%), 9 parameters demonstrated good sensitivity,
whereas 18 parameters were found to demonstrate good specificity
(Supplementary Digital Content, Table 2, http://links.lww.com/
SCS/D95).
FIGURE 5. Characteristic impressions of the features: (A) disconnected helical
impression, (B) complete helical impression, (C) close gap between antihelix
and helix, (D) distant gap between antihelix and helix, (E) connected antihelix
and helix, (F) connected antihelix and antitragus, and (G) disconnected
antihelix and antitragus.
4 #
 Volume 00, Number 00, Month 2021
FIGURE 6. Some other unique features: (A) constriction on the helix, (B)
anterior extension of antihelix, (C) characteristic depression at lobular
region, (D) characteristic Knob at the joining of helix and lobule, (E)
characteristic notch at the joining of helix and lobule, (F) characteristic notch in
inner rim of helix, (G) characteristic slope at helical lobular surface, and (H)
impression of ending of scapha.
Morphological Variations Among the Features
of Ear Prints
The foremost prominent feature of the ear is the helix. Depend-
ing upon the shape and form of the helix, the present population
demonstrated the expression of the helical prints in varying forms.
In some cases, a complete impression of the helix was seen, whereas
in other cases, the disconnected impression was recorded, as
illustrated in Figure 5A-B. Darwin tubercle was found in some
cases, whether it was present on the inner lining or the outer lining
of the helix (Fig. 2). Further, the impression of the helical root or the
crus of the helix was documented in almost all cases (Fig. 2).
The next prominent feature is the antihelix, which was found in
almost every print. The impressions of antihelix were traced in each
case (Fig. 2). The upper end of the antihelix is divided into 2
branches that is, crus superior antihelix and crus inferior antihelix.
Their impressions were documented in a few cases only (Fig. 2).
Further, it was observed in some cases that the impressions of helix
and antihelix were connected whereas in other cases, no connection
was seen. This disconnection was further reported in 2 ways that is,
close gap and distant gap (Fig. 5 C-E).
At the lower end of the antihelix, there is a depression, which is
known as the posterior auricular furrow. Further inferior to the
posterior auricular furrow, there is another elevation, called the
antitragus. It was observed that instead of the presence of the posterior
auricular furrow, the antihelix and antitragus were found to be
connected in many cases (Fig. 5F). Although in some cases it was
found to be disconnected (Fig. 5G). Opposite to the antitragus,
another elevated structure is present, which is known as the tragus.
The impression of tragus was evidenced in almost all cases (Fig. 2).
Furthermore, in between the tragus and antitragus is an inter-tragic
notch and its impressions were recorded in a few cases only (Fig. 2).
Similarly, the impressions of the earlobe were documented in some
cases (Fig. 2).
In addition to these elevated structures, depressions such as
triangular fossa, crus cavum, crus cymba, and posterior auricular
furrow, are seen in the ear. On the ear print, however, only the
boundaries of these depressions can be traced (Fig. 3). For example,
the crus of helix, crus superior antihelix, and crus inferior antihelix
enclosed a deep cavity known as the triangular fossa and from the
prints only these 3 structures or features can be traced, suggesting
the area covered by the cavity.
2021 Mutaz B. Habal, MD
CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905
The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2021
Furthermore, any structural deformity or abnormality present on
the external ear may also be expressed on the impressions of the ear.
The present study documented the presence of constriction on the
helix on the ear and its impressions (Fig. 6A).
Moreover, the present study also documented unique character-
istics of the ear, when examining the ear print, such as the anterior
extension of antihelix (Fig. 6B), characteristic depression at lobular
region (Fig. 6C), characteristic features at joining of helix and
lobule such as knob (Fig. 6D), notch (Fig. 6E), a characteristic notch
in the inner rim of the helix (Fig. 6F), the characteristic slope at the
helical lobular surface (Fig. 6G), the impression of ending of scapha
(Fig. 6H).
DISCUSSION
Anthropologists and forensic scientists have routinely examined the
variations in morphological features of different body structures to
help in the identification process. These include fingerprints, sole
prints, dental records, external ear, and so on. Every technique has
drawbacks; for example, fingerprints can be rubbed off during hard
or repetitive labor or due to adermatoglyphia or skin diseases and
dental records cannot be examined without antemortem data, etc.
Moreover, the human external ear has numerous advantages over
these techniques, such as being larger in size than other biometrics
and hence more easily captured at a distance and by closed-circuit
television cameras, ear patterns being constant throughout life, and
so on. Therefore, a different aspect of the external ear was investi-
gated in the present study in order to demonstrate its use in
personal identification.
The results of this study show that the triangular shape of the
right ear has a positive likelihood ratio of 27.44 with the triangular
shape of the ear print. Statistically, if an ear print is found to be
triangular, there is a 27.44 times greater chance that the ear is also
triangular. The study also found that the rectangular shape of the ear
is probably the most individualizing feature because it is less
frequent (2/140) in the population and its positive likelihood ratio
is very high. The finding of a rectangular ear print at the crime scene
would, therefore, be extremely helpful in the identification of the
suspect having a rectangular ear because there are very few people
with the expression of this feature.
A good individualizing morphological feature, therefore, should
have 2 characteristics: first, it is unique that is the feature should be
rare in the population, and second, the positive likelihood ratio
should be high.
Additionally, it can be stated that the expression of morphologi-
cal features on ear prints will depend upon the position, elevation,
depression, and protrusion of these features. Various stud-
ies17,18,20,30 have demonstrated that the amount of pressure applied
will also determine the expression of these structures on the ear
print. The pressure applied is directly proportional to the distortion
of the ear prints. It can change the dimension of the morphological
features of the ear prints. Therefore, constant pressure is selected for
the present study that is the period of pressure was kept constant and
special consideration was given to the pressure applied, whereas
taking the prints. However, it is subject to human errors and future
researchers are advised to devise mechanical implements for taking
ear prints with consistent results and minimum errors.
According to Meijerman et al18 and Dhanda et al21 morphologi-
cal features such as helix, antihelix, tragus, and antitragus always
leave their impressions in an ear print. This can be explained by the
prominent and elevated form of these structures of the external ear.
Similar to Meijerman et al the present study also observed that
helical impressions are manifested in 2 ways that is, connected and
disconnected (Fig. 5). The discontinuous impressions are obtained
due to the presence of elevated structures on the helix, such as
Darwin tubercle.18
# 2021 Mutaz B. Habal, MD
Characteristic Features of Ear
Although previous studies state that the helical root or crus of
the helix will almost always leave a print, 17,18 this study found it to
be true only of the superior anterior helical protrusion (Fig. 2).
Connections between antihelix and helix were seen in some cases
and differentiated into 2 types that is, close and distant, whereas in
other cases, they were connected. In the case of narrow and deep
scapha, due to the decreased space, the impressions of antihelix and
helix will meet, and appear to be connected (Fig. 5E). On the other
hand, the close and distant connections are observed in the case of
wide and shallow scapha (Fig. 5C-D). Similarly, the connection
between the antihelix and antitragus was also observed. The
presence of a shallow posterior auricular furrow was associated
with this connection on the ear print, whereas this connection was
absent in the deep posterior auricular furrow (Fig. 5F-G). Meijer-
man et al18 reported similar findings.
Furthermore, the upper 2 divisions of antihelix that is, crus
anterior and crus posterior, were expressed on ear prints only if the
superior antihelix curvature was distinct as well as elevated and the
superior helical protrusion absent. This can be explained by the fact
that whenever more pressure is applied the surrounding elevated
surfaces get depressed; thereby resulting in the expression of the
relatively less-depressed features (Fig. 2).
Tragus and antitragus, the 2 elevated surfaces on the ear, were
also expressed in ear prints, in continuation because of the impres-
sion of the outline of the inter-tragic notch (Fig. 2). They may also
appear as 2 separate patches. Further, the shape of the tragus can
occasionally be distinguished in the ear print. The knobs of the
tragus also leave their impressions.
The impression of earlobes, composed of soft cartilage, depends
upon its elevation and the pressure applied. In the present study, the
pressure applied was consistent and, therefore, the presence of
earlobes was accounted for solely based on the elevation of the
earlobes (Fig. 2).
As discussed previously, the depressed areas of the ear, such as
triangular fossa, crus cavum, crus cymba, scapha, and posterior
auricular furrow, cannot leave an impression but can be traced from
their boundaries (Fig. 3).18 The abnormalities present on the
elevated structures or leading to elevation of structures of the
external ear, such as constriction on the helix (Fig. 6A), may also
be recorded. Based on these findings, it was discovered that the
morphological features of any congenital condition of the external
ear may be absent or underdeveloped. For example, in cryptotia, the
upper helix is absent, and in prominent ears, the antihelix is not
correctly developed. In such circumstances, the morphological
traits that provide the individual with personal identification
are affected. Moreover, surgery on the external ear may alter the
morphological features, affecting the ear prints. In addition, the
effect of ear piercing was noticed in this study. An individual with
pierced ears will perceive a depression in their ear lobe prints.
The present study is a population-based study that is, it provides
generalizations only about the North Indian population. Therefore,
there is a need to investigate other populations for making general-
ized and comprehensive results.
CONCLUSIONS
The present study examined variability in the appearance of the ear
impressions and correlated these expressions with the presence of
specific features on the external ear by calculating likelihood ratios.
This study confirms that a morphological feature on the ear prints is
dependent on numerous variables, including the protuberance and
the elevations of the features of the external ear, presence of
structural abnormalities as well as the amount of pressure applied,
and can provide beneficial value in the scientific identification
of individuals.
5
CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905
Rani et al The Journal of Craniofacial Surgery
The study further reveals that individualizing morphological
features should have 2 characteristics: first, the feature should be
rare in the population, and second, the positive likelihood ratio
should be high. However, the concurrent use of multiple features
can decrease the prevalence in the population and increase the
reliability of identification.
The evidence from this study unequivocally demonstrates that
ear prints can provide important clues to assist in establishing the
identity of an individual. Further research is recommended in
different populations by using different controlled conditions such
as pressure applied for taking the ear prints.
ACKNOWLEDGMENTS
The authors thank are also due to the subjects who voluntarily
participated in the study. We are also grateful to the participants
who volunteered for the study and the principals of the colleges of
the Nahan city in Himachal Pradesh State of North India who
AQ8 allowed us data collection from their colleges.
REFERENCES
1. Ulery BT, Hicklin RA, Buscaglia J, et al. Accuracy and reliability of
forensic latent fingerprint decisions. Proc Natl Acad Sci U S A
2011;108:7733–7738
2. Abraham J, Champod C, Lennard C, et al. Modern statistical models for
forensic fingerprint examinations: a critical review. Forensic Sci Int
2013;232:131–150
3. Nirenberg MS, Krishan K, Kanchan T. A metric study of insole foot
impressions in footwear of identical twins. J Forensic Leg Med
2017;52:116–121
4. Mukhra R, Krishan K, Kanchan T. Bare footprint metric analysis
methods for comparison and identification in forensic examinations: a
review of literature. J Forensic Leg Med 2018;58:101–112
5. Mukhra R, Krishan K, Nirenberg MS, et al. Comparative analysis of
static and dynamic bare footprint dimensions in a north Indian
population. Forensic Sci Int 2020;308:110169
6. Roelofse MM, Steyn M, Becker PJ. Photo identification: facial metrical
and morphological features in South African males. Forensic Sci Int
2008;177:168–175
7. Ritz-Timme S, Gabriel P, Tutkuviene J, et al. Metric and morphological
assessment of facial features: a study on three European populations.
Forensic Sci Int 2011;207:239.e1–239.e8
8. Kaur P, Krishan K, Sharma SK. Development of human face literature
database using text mining approach: phase I. J Craniofac Surg
2018;29:966–969
9. Li X, Mills M. Vocal features: from voice identification to speech
recognition by machine. Technol Cult 2019;60:S129–S160
10. Skuk VG, Palermo R, Broemer L, et al. Autistic traits are linked to
individual differences in familiar voice identification. J Autism Dev
Disord 2019;49:2747–2767
11. Marinović D, Njirić S, Coklo M, et al. Personal identification by eyes.
Coll Antropol 2011;35 Suppl 2:347–350
12. Umer S, Sardar A, Dhara BC, et al. Person identification using fusion of
iris and periocular deep features. Neural Netw 2020;122:407–419
13. Costa VA, Caldas IM. Morphologic patterns of lip prints in a Portuguese
population: a preliminary analysis. J Forensic Sci 2012;57:1318–1322
14. Fonseca GM, Ortı́z-Contreras J, Ramı́rez-Lagos C, et al. Lip print
identification: current perspectives. J Forensic Leg Med 2019;65:32–38
15. Saadeh M, Ghafari JG, Haddad RV, et al. Sex prediction from
morphometric palatal rugae measures. J Forensic Odontostomatol
2017;35:9–20
16. Hosmani J, Gadekar NB, Kotrashetti VS, et al. Comparison of palatal
rugae pattern among Indian and Tibetan population. J Forensic Dent Sci
2018;10:40–44
17. Van der Lugt C. (Ears and) Ear prints, individualizing crime scene
marks. Prob Forensic Sci 2001;46:38–45
18. Meijerman L, Sholl S, De Conti F, et al. Exploratory study on
classification and individualization of ear prints. Forensic Sci Int
2004;140:91–99
6 #
 Volume 00, Number 00, Month 2021
19. Krishan K, Kanchan T. Identification: prints – ear. In: Payne-James J,
Byard RW, eds. Encyclopedia of Forensic and Legal Medicine. Vol 3.
2nd ed. Oxford: Elsevier; 2016:74-80
20. Kasprzak J. Identification of ear impression in polish forensic practice.
Prob Forensic Sc 2001;47:168–174
21. Dhanda V, Badhan JS, Garg RK. Studies on the development of latent
ear prints and their significance in personal identification. Prob Forensic
Sc 2011;88:285–295
22. Earprint Helps Convict a Killer. The Seattle Times. Washington, USA.
1997; Available at: https://archive.seattletimes.com/archive/
?date=19970716&slug=2549810.Accessed September 28, 2020
23. Raider Convicted by His Earprint. The Herald. Scotland. 1999;
Available at: https://www.heraldscotland.com/news/12248996.raider-
convicted-by-his-earprint/. Accessed September 18, 2020
24. Conviction Based on Earprint Thrown Out. Vancover, Washington.
1999; Available at: https://products.kitsapsun.com/archive/1999/11-19/
0030_vancouver__conviction_based_on_ea.html. Accessed September
18, 2020
25. Bennetto J. Man Convicted on ‘Earprints’ is Freed. Independent.
Independent Digital News and Media Limited, Britain. 2002; Available
at: https://www.independent.co.uk/news/uk/crime/man-convicted-on-
ear-prints-is-freed-185827.html. Accessed September 18, 2020
26. Daily Mail Reporter. Burglar Convicted After Earprint was Found at
Crime Scene Challenges Accuracy of Evidence. Britain. 2008;
Available at: https://www.dailymail.co.uk/news/article-1015599/
Burglar-convicted-ear-print-crime-scene-challenges-accuracy-
evidence.html. Accessed September 18, 2020
27. Champod C, Evett IW, Kuchler B. Earmarks as evidence: a critical
review. J Forensic Sci 2001;46:1275–1284
28. Woffinden B. Earprint Landed Innocent Man in Jail for Murder, The
Guardian, UK News. 2004; Available at: https://www.theguardian.com/
uk/2004/jan/23/ukcrime1. Accessed September 18, 2020
29. FEARID Project (Forensic Ear Identification Project). 2002; Available
at: https://cordis.europa.eu/project/id/G6RD-CT-2001-00618. Accessed
June 26, 2020
30. Habil Kasprzak J. Forensic otoscopy – a new method of human
identification. Jurisprudencija 2005;66:106–109
31. Meijerman L, Thean A, Maat GJR. Ear prints in forensic investigation.
Forensic Sci Med Pathol 2005;1:247–256
32. Meijerman L, Thean A, Van der Lugt C, et al. Individualization of ear
prints. Forensic Sci Med Pathol 2006;2:39–49
33. Kieckhoefer H, Ingleby M, Lucas G. Monitoring the physical formation
of ear prints: optical and pressure mapping evidence. Measurement
2006;39:918–935
34. Meijerman L, van der Lugt C, Maat GJR. Cross-sectional anthropometric
study of the external ear. J Forensic Sci 2007;52:286–293
35. Alberink IB, Ruifrok ACC. Performance of the FearID ear print
identification system. Forensic Sci Int 2007;166:145–154
36. Innocent Project, New York, USA. 1992; Available at: https://
www.innocenceproject.org. Accessed September 1, 2020
37. National Research Council. Strengthening Forensic Science in the
United States – A Path Forward, The National Academies Press,
Washington, DC. 2009; Available at: https://www.nap.edu/catalog/
12589/strengthening-forensic-science-in-the-united-states-a-path-
forward. Accessed September 18, 2020
38. President’s Council of Advisors on Science and Technology (PCAST)
Report. The White House President Barack Obama. Office of Science
and Technology Policy, Executive Office of the President, Washington,
DC. 2016; Available at: https://obamawhitehouse.archives.gov/sites/
default/files/microsites/ostp/PCAST/
pcast_forensic_science_report_final.pdf. Accessed September 9, 2020
39. Rani D, Krishan K, Sahani R, et al. Evaluation of morphological
characteristics of the human ear in young adults. J Craniofac Surg
2020;31:1692–1698
40. Rani D, Krishan K, Sahani R, et al. Variability in human external ear AQ9
anthropometry (Accepted January 9, 2020). Clin Ter
41. Chu K. An introduction to sensitivity, specificity, predictive values and
likelihood ratios. Emerg Med 1999;11:175–181
42. Simel DL, Samsa GP, Matchar DB. Likelihood ratios with confidence:
sample size estimation for diagnostic test studies. J Clin Epidemiol
1991;44:763–770
2021 Mutaz B. Habal, MD
CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905

The Journal of Craniofacial Surgery  Volume 00, Number 00, Month 2021 Characteristic Features of Ear

SCS Journal of Craniofacial Surgery

Manuscript No. SCS-21-0905

Dear Author,

During the preparation of your manuscript for typesetting, some queries have arisen. These are listed
below. Please check your typeset proof carefully and mark any corrections in the margin as neatly as
possible or compile them as a separate list. This form should then be returned with your marked proof/list
of corrections to the Production Editor.

QUERIES: to be answered by AUTHOR

QUERY NO. QUERY DETAILS RESPONSE

<AQ1> Please confirm whether surnames/family

names (red) have been identified
correctly in the author byline.
<AQ2> Please validate the degree for author
‘‘Kewal Krishan.’’
<AQ3> Affiliations have been set as per style.
Please check for accuracy of
information.
<AQ4> Please check and confirm the
corresponding author’s name and
relevant details for correctness and
provide postal code.
<AQ5> Please check the ‘‘Disclosure’’ section
for appropriateness.
<AQ6> Please check the changes done in the
sentence ‘‘In cases of burglary. . .’’, for
correctness.
<AQ7> Please provide the expansion of
‘‘DNA’’.
<AQ8> Please check the changes done in
‘‘Acknowledgments’’ section, for
correctness.
<AQ9> Please provide complete bibliographic
details in reference 40.

# 2021 Mutaz B. Habal, MD 7

CE: D.C.; SCS-21-0905; Total nos of Pages: 8;
SCS-21-0905

<AQ10> If you have color in your proof, please

indicate whether you approve the color
charge by returning the color agreement
with your corrections. The color
agreement can be found at http://
links.lww.com/SCS/A52. The price for
the first color figure is $500. The charge
for each additional color figure is $100.
If you prefer black and white figures,
please indicate so on your proof
corrections.