Tophaceous gout of the middle ear

Gargula, Stéphane; Poillon, Guillaume; Williams, Marc T.; Veyrat, M.; Adle‐Biassette, Homa; Denis, Arnaud

doi:10.1016/j.joto.2019.08.002

Cited by 5 publications

(14 citation statements)

References 9 publications

(13 reference statements)

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“…The sex ratio was 1/1 and the pathology is more frequent for patients over 55-years-old. The major clinical symptom was a simple progressive hearing loss ( Gargula et al., 2019 ). Abnormal otoscopy occurred in 7 out of 8 patients ( Mutlu et al., 2016 ) with 50% of white sclerotic plaque under the normal tympanic membrane.…”

Section: Discussionmentioning

confidence: 99%

Hearing loss due to urate deposition in the middle ear: A case report and literature review

Cabri-Wiltzer

Hassid

et al. 2022

Journal of Otology

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Gout is the most common cause of monoarthritis in men occurring classically in the great toe and the knee. Extra-articular gout manifestations are rare. Only a few cases of head and neck urate crystals deposits have been described in the literature. Precipitations in the middle ear cause conductive hearing loss with common otoscopic anomalies and difficult imaging diagnosis. We report a case of a healthy 58-years-old man with a middle ear urate deposit causing a progressive hearing loss as the very first symptom of gout. The nature of the deposit was unsure on computer tomography (CT) due to atypical density. The final diagnosis was revealed after surgical procedure and histologic examination. A review of the literature is also presented. Seven cases of middle ear urate deposit as the first symptom of gout were found and compared. Progressive conductive hearing loss in middle-aged patients with abnormal otoscopy and middle ear atypical density mass on CT scan must lead to a minimal surgical procedure with a histologic examination to exclude urate crystals deposits.

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Section: Discussionmentioning

confidence: 99%

Hearing loss due to urate deposition in the middle ear: A case report and literature review

Cabri-Wiltzer

Hassid

et al. 2022

Journal of Otology

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“…[1][2][3] Although conductive hearing loss due to a middle ear mass is common, a tophus in the middle ear is an uncommon cause of a middle ear mass. [3][4][5][6][7][8] The low incidence combined with the absence of clinical manifestations of gout or hyperuricemia in all known cases, including in this patient, explains why tophaceous gout in the middle ear is often misidentified as osteoma, cholesteatoma, or tympanosclerosis. 3,6,7 This emphasizes the importance of considering the diagnosis of a tophus in patients with conductive hearing loss and a mass in the middle ear.…”

Section: Discussionmentioning

confidence: 99%

Patient With Hearing Loss and a Middle Ear Mass

Neutel

Mes

Merkus

2022

JAMA Otolaryngol Head Neck Surg

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“…PTA revealed a right CHL with a 50 dB ABG, High-resolution CT on right temporal bone revealed calcified mass at the anterior part of the tympanic cleft. Pathological examination of excised mass revealed gouty tophi in ME [20] . According to V.N.G test battery results, Dix-Hallpike test revealed that 9 subjects [22.5%] in the study group presented with peripheral vertigo [BPPV], this percentage was in agreement with Lin et al [9] ; they found 21% of total number of cases of BPPV to have hyperuricemia.…”

Section: Discussionmentioning

confidence: 99%

“…I-Spontaneous nystagmus: Subject was asked to sit with head upright and the back is supported, spontaneous nystagmus observed in complete absence of any visual fixation. Minimum observation period is 30 seconds.II-Gaze test: Subject was asked to fix his vision on the light bar, 20-degree eccentric position vertical and horizontal and the eye is kept in position for20-30 seconds. III-Oculomotor tests: Subject was seated on test chair 1.5 meters from the center of the T.V.…”

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confidence: 99%

Audio-Vestibular Findings in Patients with Hyperuricemia

Al-Sobki

El-Zarea

Mahmoud

et al. 2020

International Journal of Medical Arts

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Background: Hyperuricemia is a common biochemical disturbance in which serum concentration of uric acid exceeds the normal values which is 7.0 mg/dl in men and more than 6.0 mg/dl in women leading to deposition of monosodium urate [MSU] crystals in joints and soft tissues resulting in inner ear functions affection. Aim of the work: To elaborate the effect of hyperuricemia on the peripheral hearing as well as peripheral vestibular functions. Subjects and Methods: This study included 40 subjects with hyperuricemia and 40 healthy controls. Participants underwent serum uric acid assay, full history taking, basic audiological evaluation and vestibular evaluation. Results: 37[92.5%] hyperuricemic subjects had normal peripheral hearing sensitivity, only 3[7.5%] had mild high frequencies sensori-neural hearing loss [SNHL] at 8 kHz. 31[77.5%] Hyperuricemic patients had normal peripheral vestibular functions, only 9[22.5%] subjects had BPPV; They also had higher serum uric acid [SUA] level. No correlation between duration of hyperuricemia and occurrence of BPPV. Conclusions: The hyperuricemic subjects had a significant higher incidence of BPPV. Other investigations to detect early and subtle changes in cochlear function of hyperuricemic subjects were recommended.

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Tophaceous gout of the middle ear

Abstract: We present a very rare case of tophaceous gout of the middle ear causing conductive hearing loss, with special emphasis on Computed Tomography presentation.

Cited by 5 publications

References 9 publications

Hearing loss due to urate deposition in the middle ear: A case report and literature review

Hearing loss due to urate deposition in the middle ear: A case report and literature review

Patient With Hearing Loss and a Middle Ear Mass

Audio-Vestibular Findings in Patients with Hyperuricemia

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