Audiovestibular disorders in 2 patients with relapsing polychondritis

Relapsing polychondritis (RP) is a multi-systemic inflammatory autoimmune disease that affects components of cartilage such as collagens and mucopolysaccharide. The most common findings of RP are auricular and nasal chondritis, whereas audiovestibular disorders are rarely noticed at first. We report two cases with relapsing polychondritis who first complained of audiovestibular symptoms. The first patient was a 19-year-old man, who suffered from repeated dizziness, vertigo and bilateral sensorineural hearing loss. One year later, he also had dyspnea caused by chondritis of the respiratory tract and otitis media with effusion. Results of a caloric test and vestibular evoked myogenic potential (VEMP) to clicks showed no response on either side, whereas VEMP to galvanic stimulation showed normal response on both sides. The second patient was a 58-year-old man with repeated vertigo and dizziness. He also had progressive bilateral severe sensorineural hearing impairment. Although he had undergone intravenous steroid therapy, his hearing did not recover. The results of neuro-otological examinations of our patients suggested that recurrent vertigo and dizziness in the patient with RP were mainly of labyrinthine origin.