Otolaryngologic Manifestations of Sarcoidosis: Presentation and Diagnosis

Abstract

Neuro-otologic manifestations of sarcoidosis are rare. Dizziness in particular is a rare presenting complaint of the patient afflicted with this systemic granulomatous disorder. Head and neck and sinonasal presentations of this disease are more common. We reviewed our experience with six such patients who presented for management of their otolaryngologic (ORL) manifestations in order to delineate the involvement of the otolaryngologist in the treatment and diagnosis of these patients, with a focus upon the relevant tests and procedures in the otolaryngologist's de novo diagnosis of sarcoidosis. Studies ordered in the course of otolaryngologic evaluation and their utility in the diagnosis of sarcoidosis by the otolaryngologist are reviewed and classified into useful, supportive, and ancillary. The otolaryngologist played an important role in diagnosis, with four of six patients diagnosed to have sarcoidosis on the basis of their otolaryngologic presentations. Biopsy was performed by the otolaryngologist for diagnosis of sarcoidosis in all four of these cases. Steroids were central to treatment. Oral steroid therapy was the principal treatment: both patients with neuro-otologic sarcoid were successfully managed with oral steroids. Intralesional steroids were necessary to treat the skin lesion. One of six patients patients experienced complications related to steroid use.

Otolaryngologic Manifestations of Various Rheumatic Diseases: Awareness and Practice Among Otolaryngologists

“…Although otolaryngologic manifestations of various rheumatic diseases have been well described, awareness among otolaryngologists regarding these manifestations is negligible. [2][3][4][5][6][7][8][9] Early and accurate diagnosis with prompt treatment or referral to specialists may prevent morbidity and mortality related to these diseases. The present study was designed to assess the understanding and practice about various ENT problems of rheumatic diseases amongst otolaryngologists.…”

Orofacial Sarcoidosis and Granulomatosis

“…The reported falsepositive and false-negative rates for the SACE level as a laboratory marker of sarcoidosis are 10 and 40 percent, respectively. (Schultz et al, 1979 ;Chesnutt & Enigmas, 1995 ;Shah et al, 1997 ;Rybicki et al,1998) …”

Sinonasal involvement in sarcoidosis: a report of seven cases and review of literature

“…Later, several studies have described upper respiratory tract involvement in general and sinonasal manifestations in particular [5][6][7][8][9][10][11][12][13][14].…”