Otolaryngeal Manifestations of Behçet’s Disease in a Northern European population
F. Adeeb (1,3), C.W.R. Fitzgerald (1), C.V. Timon (2), N.P. Shine (1), J.P. Hughes (3), A.D. Fraser (1,3)
1. University Hospital Limerick, Dooradoyle, Limerick, Ireland; 2. Royal Victoria Eye and Ear Hospital, Dublin, Ireland; 3. University of Limerick, Graduate Entry Medical School, Limerick, Ireland
Behçet’s Disease (BD) is a complex, inflammatory, systemic disease of unknown etiology, typically affecting the triad of oral and genital mucosa and the eye. The Otolaryngology-related manifestations of BD, though previously described, are said to be relatively rare and have been less thoroughly explored in the literature.
The aim of this study was to undertake an otolaryngeal assessment of a cohort of BD patients in University Hospital Limerick, Ireland.
Behcet’s patients fulfilling the International Study Group for Behçet’s Disease (ISGBD) or the International Criteria for Behçet’s Disease (ICBD) criteria for diagnosis were included in the study and underwent assessment with an otolaryngologist, which include flexible laryngoscopy. Intraoral, pharyngeal and laryngeal manifestations of BD were documented and characterised. Patients also underwent hearing assessment with pure-tone audiometry.
Fifteen BD patients were identified (4 male, 11 female; median age 36 years). 60% (n=9) showed evidence of disease on examination and flexible laryngoscopy. 33% (n=5) including two asymptomatic patients showed structural laryngeal changes related to BD. 13% (n=2) demonstrated bilateral, symmetrical sensorineural hearing loss. One patient warranted consideration for tracheotomy.
Our cohort demonstrate significant structural laryngeal changes, which appear to be more common than was previously thought. Raised awareness of the risk of laryngeal pathology in BD patients, including potential risk for later airway compromise, even in the absence of overt clinical symptomatology, and early screening may result in earlier diagnosis and treatment. Rheumatologists and Otolaryngologists should consider closer multi-disciplinary co-operation in the management and follow up of patients with BD.