{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:18:19Z","timestamp":1788326299431,"version":"build-2803163510"},"reference-count":19,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Auricular asymmetry affects facial aesthetics; yet, the degree of asymmetry discernible by a casual observer remains poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To measure the casual observer\u2019s perception of auricular size, angulation, protrusion, and vertical position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Artificial intelligence-generated facial images were utilized and unilateral variations created in (1) size, (2) angulation, (3) protrusion, and (4) vertical position. A total of 200 responders reviewed 46 images, rating the ear appearance on a Likert scale of 0\u201310.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Causal observers rated a \u226510% change in size significantly different than baseline (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Retrograde angulation \u226510\u00b0 and anterograde angulation at 20\u00b0 were rated significantly different than baseline (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Positive asymmetrical protrusion was rated more severely than negative asymmetrical protrusion. The vertical position difference was rated least critically on average compared with baseline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Casual observers more critically perceived auricular size asymmetry and retrograde angulation when compared with protrusion and vertical position asymmetry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26893614251407676","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T09:50:36Z","timestamp":1770198636000},"page":"523-528","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ear Size and Position Variations Rated by Casual Observers on Artificial Intelligence-Generated Models"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3234-5219","authenticated-orcid":false,"given":"Kai C.","family":"Kokesh","sequence":"first","affiliation":[{"name":"School of Medicine, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Sie","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2014Head and Neck Surgery, Seattle Children\u2019s Hospital, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Bly","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2014Head and Neck Surgery, Seattle Children\u2019s Hospital, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bhrany","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Modi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2014Head and Neck Surgery, Seattle Children\u2019s Hospital, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annique","family":"Nyman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2014Head and Neck Surgery, Seattle Children\u2019s Hospital, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Nina","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2021.08.004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpra.2023.06.004"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2016.06.011"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2017.12.017"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-024-03989-0"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjw271"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24331"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2017.2402"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004851"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182326dfb"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(94)90143-0"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2020.06.002"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12134499"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1630"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2014.12.019"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2021.0265"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2020.12.064"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1288921"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1992_029_0324_agsote_2.3.co_2"}],"container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26893614251407676","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26893614251407676","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26893614251407676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:25:07Z","timestamp":1788323107000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26893614251407676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1177\/26893614251407676"],"URL":"https:\/\/doi.org\/10.1177\/26893614251407676","relation":{},"ISSN":["2689-3614","2689-3622"],"issn-type":[{"value":"2689-3614","type":"print"},{"value":"2689-3622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]}}}