Larngeal Manifestations of Relapsing Polychondritis

Abstract

The incidence of Relapsing Polychondritis is estimated to be 3.5 cases per million with only 600 cases being reported in the world. It can affect any age ranging from 5 to 84 years with predominance in the fourth and fifth decade. Male to female ratio varies from 1:1 to 1:3. It is believed to be an immunologic reaction to collagen Type II which is predominantly presented in the cartilaginous structures of the body and in the eye. The diagnosis is based on the presence of three or more clinical signs, one clinical sign in addition to histological confirmation, or involvement of two or more sites with a favorable response to treatment based on Mc Adam diagnostic criteria. The otolaryngologic manifestations of RP span the ears, nose, larynx and tracheobronchial tree. The symptoms include change in voice quality, respiratory discomfort, stridor, dyspnea, cough, chocking, anterior neck tenderness mainly over the thyroid cartilage and cricoid cartilages, aspiration and difficulty in swallowing. The laryngeal manifestations should be evaluated using high resolution computerized tomography, Magnetic resonance imaging, pulmonary function testing, plain radiography and pulmonary function testing.

Laryngeal Fracture following Violent Sneeze: Management and Biomechanical Analysis

“…The most common of these is relapsing polychondritis, an autoimmune disease affecting cartilage, with 50% of patients having airway involvement. 3…”

“…Inflammatory conditions of the cartilage should also be considered when pathologic fracture is a possibility. The most common of these is relapsing polychondritis, an autoimmune disease affecting cartilage, with 50% of patients having airway involvement 3 …”

“…The most common of these is relapsing polychondritis, an autoimmune disease affecting cartilage, with 50% of patients having airway involvement. 3 Few cases of thyroid cartilage fracture following a sneeze or cough have been reported since 1950, and none have included a biomechanical analysis of how such a seemingly preposterous event may occur. Variables contributing to the force of a sneeze include body position, open or closed mouth, and attempts to suppress the sneeze.…”