Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (4): 12-16.doi: 10.6040/j.issn.1673-3770.0.2021.234

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Bilateral ossification of the auricular cartilage: a case report and literature review

LIU Bo, XIAO Xuping, LI Yunqiu, ZHOU En, GUO Renbin   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The First Affiliated Hospital of Hunan Normal University / Hunan provincial People's Hospital, Changsha 410005, Hunan, China
  • Online:2022-07-20 Published:2022-07-11

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Abstract: Objective The study aimed to explore the pathogenesis, clinical manifestations, diagnostic basis, differential diagnoses, and treatment methods of auricular cartilage ossification. Methods The clinical data of a patient with auricular cartilage ossification was retrospectively analyzed. A review of related literature was included for summary. Results The pathogenesis of auricular cartilage ossification is yet to be elucidated. Obvious discomfort is not a common finding; however, a few cases may present with local pain, hearing loss, and other symptoms. Computerized tomography of the temporal bone aids in diagnosis, but histopathological examination dictates the final diagnosis. Patients with no obvious symptoms may opt for temporary observation. However, surgical management is the treatment of choice if quality of life and function are affected. Conclusion Auricular cartilage ossification is relatively uncommon in clinical practice, and currently, no treatments have been developed to reverse its course. Active risk identification and early intervention are key to prevent disease progression.

Key words: Auricular cartilage ossification, Petrified auricle, Ectopic ossification, Ectopic calcification, Elastic cartilage

CLC Number: 

  • R765.21
[1] 毛玉江, 王满宜, 吴新宝. 异位骨化[J]. 中华创伤骨科杂志, 2004, 8:913-917. doi: 10.3760/cma.j.issn.1671-7600.2004.08.020.
[2] 冷辉, 张琦, 王爱平, 等. 双侧耳廓软骨骨化一例[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(11): 1075-1076. doi:10.3760/cma.j.cn115330-20191206-00746. LENG Hui, ZHANG Qi, WANG Aiping, et al. Ossification of bilateral auricle cartilage: a case report[J]. Chin J Otorhinolaryngol Head Neck Surg, 2020, 55(11): 1075-1076. doi:10.3760/cma.j.cn115330-20191206-00746.
[3] Shah A, Khorshid SM, Suchak R, et al. Unilateral petrified ear[J]. Clin Exp Dermatol, 2019, 44(3): 310-312. doi:10.1111/ced.13698.
[4] 伊海金, 杨仕明. 重视耳部外伤诊疗工作[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 1-3. doi: 10.6040/j.issn.1673-3770.1.2019.045. YI Haijin, YANG Shiming. Value the diagnosis and treatment of ear trauma[J]. J Otolaryngol Ophthalmol Shandong Univ, 2020, 34(1): 1-3. doi: 10.6040/j.issn.1673-3770.1.2019.045.
[5] Karrs JX, Bass J, Karrs T. Inflexible ears[J]. JAMA Dermatol, 2016, 152(3): 335. doi:10.1001/jamadermatol.2015.4761.
[6] Scherrer FW. LXVII. calcification and ossification of the external ears. Ann Otol Rhinol Laryngol[M]. California:SAGE Publications, 1932, 41(3): 867-885. doi:10.1177/000348943204100315.
[7] Gordon DL. Calcification of auricular cartilage[J]. Arch Intern Med, 1964, 113: 23-27. doi:10.1001/archinte.1964.00280070025006.
[8] Lister GD. Ossification in the elastic cartilage of the ear[J]. Br J Surg, 1969, 56(5): 399-400. doi:10.1002/bjs.1800560522.
[9] DiBartolomeo JR. The petrified auricle: comments on ossification, calcification and exostoses of the external ear[J]. Laryngoscope, 1985, 95(5): 566-576.
[10] Cohen AM, Talmi YP, Floru S, et al. Ossification of the auricle in Addison's disease[J]. J Laryngol Otol, 1989, 103(9): 885-886. doi:10.1017/s0022215100110400.
[11] Lari AA, al-Rabah N, Dashti H. Acrobatic ears: a cause of petrified auricles[J]. Br J Plast Surg, 1989, 42(6): 719-721. doi: 10.1016/0007-1226(89)90088-X.
[12] Cohen AM, Talmi YP, Floru S, et al. X-ray microanalysis of ossified auricles in Addison's disease[J]. Calcif Tissue Int, 1991, 48(2): 88-92. doi:10.1007/bf02555872.
[13] Lautenschlager S, Itin PH, Rufli T. The petrified ear[J]. Dermatology, 1994, 189(4): 435-436. doi:10.1159/000246903.
[14] Yeatman JM, Varigos GA. Auricular ossification[J]. Australas J Dermatol, 1998, 39(4): 268-270. doi:10.1111/j.1440-0960.1998.tb01489.x.
[15] Stites PC, Boyd AS, Zic J. Auricular ossificans(ectopic ossification of the auricle)[J]. J Am Acad Dermatol, 2003, 49(1): 142-144. doi: 10.1067/mjd.2003.320.
[16] High WA, Larson MJ, Hoang MP. Idiopathic bilateral auricular ossificans: a case report and review of the literature[J]. Arch Pathol Lab Med, 2004, 128(12):1432-1434. doi: 10.1043/1543-2165(2004)1282.0.CO;2.
[17] Manni JJ, Berénos-Riley LCM. Ossification of the external ear: a case report and review of the literature[J]. Eur Arch Oto-Rhino-Laryngol Head Neck, 2005, 262(12): 961-964. doi:10.1007/s00405-005-0931-4.
[18] González-Sixto B, García-Doval I, Conde A, et al. Bilateral ossification of the auricular cartilage[J]. Actas Dermosifiliogr, 2006, 97(2): 134-135. doi:10.1016/s0001-7310(06)73366-x.
[19] Sterneberg-Vos H, Winnepenninckx V, Frank J, et al. Ossification of the auricle[J]. Int J Dermatol, 2007, 46(s3): 42-44. doi:10.1111/j.1365-4632.2007.03512.x.
[20] Carfrae MJ, Foyt D. Auricular ossification resulting in external auditory canal stenosis. Ear Nose Throat J, 2008, 87(3): 148-149. doi: 10.1177/014556130808700309.
[21] Mastronikolis NS, Zampakis P, Kalogeropoulou C, et al. Bilateral ossification of the auricles: an unusual entity and review of the literature[J]. Head Face Med, 2009, 5: 17. doi:10.1186/1746-160X-5-17.
[22] 文振华, 李敬扬, 何静芸. 耳廓软骨骨化1例[J]. 中国耳鼻咽喉头颈外科, 2020,27(5): 296. doi:10.16066/j.1672-7002.2020.05.019.
[23] 张琦, 禹卉千, 李振鲁. 耳廓软骨骨化一例[J]. 中华皮肤科杂志, 2018,51(8): 628-629. doi: 10.3760/cma.j.issn.0412-4030.2018.08.025.
[24] Chalmers J, Gray DH, Rush J. Observations on the induction of bone in soft tissues[J]. J Bone Joint Surg Br, 1975, 2, 57(1): 36-45. doi: 10.1302/0301-620X.57B1.36.
[25] 田鹏, 刘军, 马信龙. 内皮间质转化参与异位骨化的研究进展[J]. 中国矫形外科杂志, 2021, 29(5): 433-436. doi: 10.3977/j.issn.1005-8478.2021.05.11. TIAN Peng, LIU Jun, MA Xinlong. Research progress of endothelial-mesenchymal transition in heterotopic ossification[J]. Orthop J China, 2021,29(5): 433-436. doi: 10.3977/j.issn.1005-8478.2021.05.11.
[26] Łęegosz P, Drela K, Pulik Ł, et al. Challenges of heterotopic ossification-Molecular background and current treatment strategies[J]. Clin Exp Pharmacol Physiol, 2018, 45(12): 1229-1235. doi:10.1111/1440-1681.13025.
[27] Ranganathan K, Loder S, Agarwal S, et al. Heterotopic ossification: basic-science principles and clinical correlates[J]. J Bone Joint Surg Am, 2015, 97(13): 1101-1111. doi:10.2106/jbjs.n.01056.
[28] 鞠金勇, 肖海军, 石伟哲, 等. 诱导异位骨化信号转导通路的研究进展[J]. 国际骨科学杂志, 2015,36(6): 436-440. doi: 10.3969/j.issn.1673-7083.2015.06.013.
[29] Fujioka K, Kishida T, Ejima A, et al. Inhibition of osteoclastogenesis by osteoblast-like cells genetically engineered to produce interleukin-10[J]. Biochem Biophys Res Commun, 2015, 456(3):785-791. doi: 10.1016/j.bbrc.2014.12.040.
[30] Lin L, Shen Q, Leng HJ, et al. Synergistic inhibition of endochondral bone formation by silencing Hif1α and Runx2 in trauma-induced heterotopic ossification[J]. Mol Ther, 2011, 19(8): 1426-1432. doi:10.1038/mt.2011.101.
[31] Harker DB, Word AP, Kia K. Idiopathic bilateral auricular ossificans[J]. Cutis, 2019, 104(2): E18-E19. PMID: 31603971.
[32] Jessie Aw, Rebecca Davies, John-Luke Cook. Stone deaf: the petrified ear-case report and review of the literature[J]. Radiol Case Rep, 2011, 6(2): 430. doi:10.2484/rcr.v6i2.430.
[33] Recalcati S, Fantini F. Petrified ears: a clue for adrenal insufficiency[J]. Dermatopathology(Basel), 2021, 8(1): 45-48. doi:10.3390/dermatopathology8010009.
[34] Weiss E, Degesys CA, Stroud CM. Petrified ear-A case report and review of the literature[J]. Dermatol Online J, 2017, 23(2): 13030/qt207579b9. doi:10.5070/d3232033970.
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