Otologic manifestations of relapsing polychondritis. Review of literature and report of nine cases.
OBJECTIVE
Relapsing polychondritis (RP) is an episodic disease most likely of autoimmune etiology, characterized by recurrent inflammation of cartilaginous structures.


METHODS
Retrospective case study at two tertiary referral centers with presentation of nine patients with otologic involvement of RP, review of the spectrum of otologic disorders seen, and treatment.


RESULTS
The clinical course of otologic manifestations of RP was highly variable and ranged from mild to moderate. In 6/9 patients there was an association with other autoimmune disorders. In addition to recurrent auricular chondritis, which was present in 8/9 patients, our patients had otitis externa, chronic myringitis, Eustachian tube dysfunction, conductive hearing loss, sensorineural hearing loss, and tinnitus. All patients had their diagnosis of RP made on the basis of their otologic involvement and the response to systemic corticosteroids.


CONCLUSIONS
The diagnosis of RP is primarily clinical, but laboratory studies and biopsy may contribute as well. Once the diagnosis is suspected, the otolaryngologist should consider consultation with a rheumatologist to assist in the management of additional systemic manifestations.
Bachor
Edgar
E
Universitäts-HNO Klinik, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany. ebmail@web.de
Blevins
Nikolas H
NH
Karmody
Collin
C
Kühnel
Thomas
T
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D001706:Biopsy; D003937:Diagnosis, Differential; D004427:Ear Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005064:Eustachian Tube / Q000503:physiopathology; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000453:epidemiology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000175:diagnosis* / Q000453:epidemiology; D010033:Otitis Media / Q000175:diagnosis* / Q000453:epidemiology; D011081:Polychondritis, Relapsing / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014012:Tinnitus / Q000453:epidemiology
D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear