Abstract
Objectives .
Sarcoidosis is a multisystemic inflammatory disease with extrathoracic
manifestations, most commonly affecting the young and middle-aged,
female and black populations. Diagnosis usually requires evidence of
non-caseating granulomata and, when treated, prognosis is usually
favourable. We aim to establish the incidence, clinical features and
optimal treatment of ENT manifestations of this disease.
Design .
We performed a review of the literature to determine the evidence-base
supporting this.
Results .
ENT manifestations are present in 10-15% of patients with sarcoidosis,
often as a presenting feature, and require vigilance for swift
recognition and coordinated additional treatment specific to the organ.
Laryngeal sarcoidosis presents with difficulty in breathing, dysphonia
and cough, and may be treated by Speech and Language Therapy (SLT) or
intralesional injection, dilatation or tissue reduction. Nasal disease
presents with crusting, rhinitis, nasal obstruction and anosmia, usually
without sinus involvement. It is treated by topical nasal or
intralesional treatments but may also require endoscopic sinus surgery,
laser treatment or even nasal reconstruction. Otological disease is
uncommon but includes audiovestibular symptoms, both sensorineural and
conductive hearing loss, and skin lesions.
Conclusions .
The consequences of ENT manifestations of sarcoidosis can be
uncomfortable, disabling and even life threatening. Effective management
strategies require good diagnostic skills and use of specific therapies
combined with established treatments such as corticosteroids.
Comparisons of treatment outcomes are needed to establish best practice
in this area.