Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T14:55:56.281Z Has data issue: false hasContentIssue false
  • English
  • Français

An unusual dark pigmentation on the tympanic membrane

Published online by Cambridge University Press:  05 August 2011

M Sagit ,
M Uludag  and
I San
M Sagit*
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Kayseri Training and Research Hospital, Sanliurfa, Turkey
M Uludag
Affiliation:
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Harran University, Sanliurfa, Turkey
I San
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Harran University, Sanliurfa, Turkey
*
Address for correspondence: Dr Mustafa Sagit, Kayseri Eğitim ve Araştırma Hastanesi KBB Kliniği, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No: 78 38010 KAYSERİ/TURKEY Fax: +90 352 320 73 13 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To report an extremely rare case of dark pigmentation on the tympanic membrane due to alkaptonuria, and to discuss the probable association between this condition and hearing loss.

Case report:

A 58-year-old man with alkaptonuria was admitted with tinnitus and hearing loss in both ears. Physical examination showed bluish-black pigmentation on the helixes of both ears and both sclerae. Otoscopic examination revealed dark discolouration of both tympanic membranes. Audiological evaluation revealed mixed high frequency hearing loss in both ears. Tympanometric examination revealed type A tympanograms bilaterally, and absence of acoustic reflexes both ipsilaterally and contralaterally. Computed tomography of the temporal bones revealed no abnormality.

Conclusion:

Clinicians should consider alkaptonuria in the differential diagnosis of patients with abnormal tympanic membrane pigmentation and hearing loss.

Keywords

Hearing LossPigmentationAlkaptonuriaTympanic Membrane
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 10 , October 2011 , pp. 1059 - 1061
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fernandez-Canon, JM, Granadino, B, Beltran-Valero de Bernabe, D, Renedo, M, Fernandez-Ruiz, E, Penalva, MA et al. The molecular basis of alkaptonuria. Nat Genet 1996;14:19–24CrossRefGoogle ScholarPubMed
2Keller, JM, Macaulay, W, Nercessian, OA, Jaffe, IA. New developments in ochronosis: review of the literature. Rheumatol Int 2005;25:81–5CrossRefGoogle ScholarPubMed
3Hamdi, N, Cooke, TD, Hassan, B. Ochronotic arthropathy: case report and review of literature. Int Orthop 1999;23:122–5CrossRefGoogle Scholar
4Ferreira, M, Sanches, M, Lobo, I, Selores, M. Alkaptonuric ochronosis. Eur J Dermatol 2007;17:336–7Google ScholarPubMed
5Ibrahim, FA, El-din Selim, MM, Al-Ansari, H. Ochronosis-A Review. The Gulf J Dermatol Venereol 2002;9:1–8Google Scholar
6Maathuis, PG, Driessen, AP. Painted black. Ann Rheum Dis 2002;61:100–1CrossRefGoogle ScholarPubMed
7Pau, HW. Involvement of the tympanic membrane and ear ossicle system in ochronotic alkaptonuria. Laryngol Rhinol Otol 1984;63:541–4CrossRefGoogle ScholarPubMed
8Zhao, BH, Chen, BC, Shao de, C, Zhang, Q. Osteoarthritis? Ochronotic arthritis! A case study and review of the literature. Knee Surg Sports Traumatol Arthrosc 2009;17:778–81CrossRefGoogle ScholarPubMed
9Balatsouras, DG, Dimitropoulos, P, Fassolis, A, Kloutsos, G, Economou, NC, Korres, S et al. Bilateral spontaneous hemotympanum: case report. Head Face Med 2006;2:31 doi:10.1186/1746-160X-2-31, http://www.head-face-med.com/content/2/1/31CrossRefGoogle Scholar
10Gadre, AK. Cholesterol, granuloma. Ear Nose Throat J 2005;84(5):264CrossRefGoogle Scholar
11Williams, J, Sharma, A, Prinsley, P. Bilateral jugular bulb dehiscence in achondroplasia. Int J Pediatr Otorhinolaryngol 2006;1:164–6CrossRefGoogle Scholar
12Neto, ME, Vuono, IM, Souza, LR, Testa, JR, Pizarro, GU, Barros, F. Tympanic paragangliomas: case reports. Braz J Otorhinolaryngol 2005;71:97–100Google ScholarPubMed
13Suwannarat, P, Phornphutkul, C, Bernardini, I, Turner, M, Gahl, WA. Minocycline-induced hyperpigmentation masquerading as alkaptonuria in individuals with joint pain. Arthritis Rheum 2004;50:3698–701CrossRefGoogle ScholarPubMed
14Peker, E, Yonden, Z, Sogut, S. From darkening urine to early diagnosis of alkaptonuria. Indian J Dermatol Venereol Leprol 2008;74:700 DOI: 10.4103/0378-6323.45142CrossRefGoogle Scholar