Gout and Its Manifestations in the Head and Neck

Stark, Thomas W.; Hirokawa, Ronald H.

doi:10.1016/s0030-6665(20)32154-x

Cited by 14 publications

(5 citation statements)

References 5 publications

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“…Acute gouty arthritis can be precipitated by surgery and therefore peri-operative colchine is recommended. 5 The development of tophaceous gout itself represents a chronic failure to control plasma urate and, therefore, post-operative risk factor modification and medical therapy needs to be maximized to prevent recurrence and further surgery. 4 In conclusion, we describe the first documented case of nasal tophaceous gout removal with a powered microdebrider under endoscopic control.…”

Section: Discussionmentioning

confidence: 99%

“…However, there have been diverse manifestations described in the head and neck region 4 including involvement of the cricoarytenoid, sternoclavicular and temporomandibular joints. 1 Tophaceous gout commonly affects the outer helix of the pinna, 5 but has also been reported as affecting the arytenoid cartilages, 6 thyroid cartilage, 7 vocal folds, 8,9 hyoid bone 10 and tongue. 11 The diagnosis of gout is made by the identification of monosodium urate crystals in either synovial fluid or in a tissue specimen.…”

Section: Introductionmentioning

confidence: 99%

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Tophaceous gout presenting as a dorsal nasal lump

2005

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A literature review reveals that gout has been described as affecting many sites in the head and neck region, both in the arthritic and tophaceous form. Gout can often mimic malignancy or infection, and has been described as causing acute airway problems requiring emergency tracheotomy. Here we describe the first published case of tophaceous gout affecting the soft tissues overlying the nasal bones. The patient presented with a bony, hard, dorsal hump and requested aesthetic rhinoplasty. We also describe an endoscopic technique for removal of tophi using a powered microdebrider system with a protected burr head. Endoscopic powered microdebrider blade excision of tophi affecting the limbs has already been described, with reduced complications when compared with conventional curettage and debridement techniques. This is the first such application to the nose.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tophaceous gout presenting as a dorsal nasal lump

2005

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“…Documented sites of involvement in the head and neck include the arytenoid, true vocal cord, hyoid bone, thyroid cartilage, cricoarytenoid joint, soft tissues of the nasal dorsum, nasal septum, temperomandibular joint, soft palate, cervical spine, and glossoepiglottic ligament. Laryngeal involvement can cause airway compromise and mucosal changes that mimic squamous cell carcinoma 4 …”

Section: Discussionmentioning

confidence: 99%

“…Laryngeal involvement can cause airway compromise and mucosal changes that mimic squamous cell carcinoma. 4 Tophi of the auricle are usually asymptomatic but can become inflamed and occasionally ulcerate through their thin overlying skin as chalky yellow-white material. Chronic tophaceous gout is treated with dietary modification, the xanthine oxidase inhibitor allopurinol, and uricosuric agents like probenecid.…”

Section: Discussionmentioning

confidence: 99%

Auricular tophi as the initial presentation of gout

Griffin

Munns

Fullen

et al. 2009

Otolaryngol.--head neck surg.

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“…The external ear, especially the helix, is one of the most common sites of tophus formation in the head and neck region. Documented sites of involvement in the head and neck include the arytenoid, true vocal cord, hyoid bone, thyroid cartilage, nasal septum, temporomandibular joint, soft palate, cervical spine, and glossoepiglottic ligament [ 5 ] Tophi of the auricle are usually asymptomatic. Dietary modification and medication use (e.g., a xanthine oxidase inhibitor such as allopurinol or a uricosuric agent such as probenecid) are recommended.…”

Section: Case Presentationmentioning

confidence: 99%

Gout with auricular tophi following anti-tuberculosis treatment: a case report

et al. 2013

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BackgroundAuricular tophi are firm deposits of monosodium urate in crystal form, which may slowly develop in subcutaneous tissue of the ear. Ear is not usual locations for gout tophi, but when this growth does occur, helix and the antihelix are common sites.Case presentationWe present a 64-year-old man who had multiple painless nodules over bilateral helix. An excisional biopsy was performed. Hematoxylin-eosin staining of biopsy specimens revealed a proteinaceous matrix that surrounded dissolved crystals, consistent with gout tophi. Bilateral auricular tophi are not common and may resemble a number of other diseases including squamous cell carcinomas, Kaposi’s sarcoma, epidermal and dermoid cysts, rheumatoid nodules. Biopsy should be performed to rule out malignancy.ConclusionsTophi of the auricle are usually asymptomatic but can become inflamed and occasionally ulcerate through the overlying skin. Chronic tophaceous gout is treated with dietary control and medication. Surgical excision is performed under local anesthetic if symptoms progression or cosmetically deformity is concerned.

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Gout and Its Manifestations in the Head and Neck

Cited by 14 publications

References 5 publications

Tophaceous gout presenting as a dorsal nasal lump

Tophaceous gout presenting as a dorsal nasal lump

Auricular tophi as the initial presentation of gout

Gout with auricular tophi following anti-tuberculosis treatment: a case report

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