Otologic manifestations of relapsing polychondritis

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.

CONCLUSION

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.

Recurrent chondrosarcoma of the hyoid bone

Chondrosarcoma is a malignant tumor of cartilaginous origin, and the second most common primary malignant bone tumor in the United States. Only approximately 10% of chondrosarcomas occur in the head and neck region, and of these the hyoid bone is a rare site of involvement. This report describes such a case, as well as the radiographic features as seen by CT scan.