Bilateral Ossification of the Auricular Cartilage

Endocrine Petrified Ear: Associated Endocrine Conditions in Auricular Calcification/Ossification (A Sample-Focused Analysis)

“…Studies to address the identification of auricular calcifications/ossifications amid CT scans according to our methods [7,15]. Overall, the data coming from our sample-based analysis via isolated case reports (N = 49 subjects) showed that X-ray and/or CT confirmation was done in all cases (no differences were noted in imagery approaching the patients with an endocrine [1,6,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] versus non-endocrine [2,4,7,9,12,36,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]…”

“…Table 1. Endocrine petrified ear: the published data with concern to the diagnosis of petrified ear that associated a prior or current diagnosis of an endocrine condition (autoimmune or not) according to our methods; the display starts with the most recent publication date [1,6,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Abbreviations: ACTH = adrenocorticotropic hormone; antiTPO = anti-thyroperoxidase antibodies; B/U = bilateral or unilateral ear involvement; 3D = three-dimensional; C1 = case 1 (patient from a case series); CT = computed tomography; F = female; FSH = follicle-stimulating hormone; GH-RH = growth hormone-releasing hormone; LH = luteinizing hormone; HU = Hounsfield units; MRI = magnetic resonance imagery; M = male; NSAI = non-steroidal anti-inflammatory drug; PE = petrified ear; PTH = parathormone; SPECT = single-photon emission CT; T4 = levothyroxine; Tc = technetium; TSH = thyroid-stimulating hormone.…”

“…The hormonal assessments were provided in the endocrine cases [1,6,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39], but, also, as mentioned, in non-endocrine cases (to some extent) [2,4,7,9,12,36,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. Despite large variations in reporting an endocrine profile, the main evaluation included:…”

“…The admission (which allowed the confirmation of the rigid/petrified pinna in patients with endocrine diseases) was done for various purposes as following: self-palpation of rigid pinna and bilateral stenotic external ear canals (N = 1) [21] progressive rigid pinna and hearing loss (N = 2) [6,18] intermittent ear pain (N = 1) [1,34] progressive rigid pinna (N = 2) [36,37] progressive rigid pinna and recurrent weakness due to adrenal insufficiency (N = 1) [22] acute pericarditis (N = 1) [23] acute adrenal insufficiency (N = 5) [25,28,29,31,32] ulcerative colitis (N = 1) [20] Overall, we identified several types of endocrine-and auricular-related diagnosis patterns with respect to the timeline of identification: Generally, the complains of the rigid pinna (intermittent pain or pain during certain sleeping positions) or the self-palpation of the rigid helix were presented for years before the actual diagnosis of the petrified ear [1,18,26,34]; the maximum period of time was of 20 years [18] in the endocrine cohort, and these patients had a certain hormonal anomaly that may be associated or not with the auricular lesion. A concomitant diagnosis of the endocrine disease (and other co-morbidities) and of the calcified pinna was established [20,23,30,32].…”

“…Prior history of an endocrine condition was followed by the self-detection of a rigid pinna [22,26]; the longest time frame between the endocrine diagnosis and the petrified ear diagnosis was of 20 years [22]. Prior endocrine disease with clinical detection of the petrified ear amid hospitalization for these already known hormonal issues [6,27,31,33,35] Detection of the rigid pinna was followed by an endocrine diagnosis [28,[36][37][38]; the maximum length of this time window was of 6 years [37], respectively, of 10 years [38] (Figure 2). Notably, the hormonal panel was essential, even as a retrospective diagnosis; for instance, Machado et al [32] published the first case of postpartum hypopituitarism due to autoimmune hypophysitis, but 15 years after the patient delivered her baby.…”