title: Otolaryngology fantastica: the ear, nose, and throat manifestations of Munchausen's syndrome.
abstract: OBJECTIVE
  Munchausen's syndrome (MS) is a form of severe, chronic, factitious disorder with physical symptoms. Some essential features define MS, such as recurrent, feigned, or simulated illness; peregrination (traveling or wandering); pseudologia fantastica; and drug abuse. Munchausen's syndrome by proxy (MSBP) classically involves a parent or other caregiver who inflicts injury or induces illness in a child. The aim of the present study was to summarize and study the main ear, nose, and throat (ENT) manifestations of MS and MSBP.
  
  
  METHODS
  A systematic literature review carried out in a tertiary university referral center.
  
  
  METHODS
  An appropriate string was run on PubMed to retrieve articles dealing with ENT manifestations of MS and MSBP. A double cross-check was performed on citations and full-text articles found using selected inclusion and exclusion criteria.
  
  
  RESULTS
  In total, 24 articles were finally included in the study, describing 30 cases of MS or MSBP involving the ENT region; 15/30 (50%) cases involved the face, most often presenting as facial pain or facial swelling; and 7/30 (23.3%) cases presented with symptoms involving the ear. Six cases out of 30 (20%) were MSBP.
  
  
  CONCLUSIONS
  MS and MSBP may present with symptoms involving the head and neck area, particularly the face and external ear canal. The ENT specialist should suspect MS in patients with strange and long-lasting symptoms, so as to avoid misdiagnosis and unnecessary treatments that waste time and money in the healthcare sector.
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Alicandri-Ciufelli
authors.forename: Valentina
authors.initials: V
authors.lastname: Moretti
authors.forename: Marco
authors.initials: M
authors.lastname: Ruberto
authors.forename: Daniele
authors.initials: D
authors.lastname: Monzani
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiarini
authors.forename: Livio
authors.initials: L
authors.lastname: Presutti
mesh_terms: D006801:Humans; D009110:Munchausen Syndrome / Q000175:diagnosis*; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis*; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis*