Tophaceous
gout and pseudogout of the middle ear and the infratemporal fossa:
case report and review of the literature. J Otolaryngol. 2003
Aug;32(4):269-72.
Case records of
the Massachusetts General Hospital. Weekly clinicopathological
exercises. Case 29-1996. A 59-year-old man with gout and a painful
preauricular mass.N Engl J Med.1996 Sep 19;335(12):876-81.
Gout tophus of
the middle ear. HNO.1990 Dec;38(12):465-7.
An unusual
case of a patient with a gouty tophus in the middle ear is
presented. The patient had no clinical or laboratory signs of
hyperuricaemia. The findings in the middle ear are discussed with
reference to current knowledge of the pathogenesis of gout.
Infratemporal
gout tophus--a rare differential diagnosis in primary parotid gland
disease. Laryngorhinootologie.1989 Nov;68(11):638-41.
Soft-tissue
tophi can be observed in up to 50% of patients with primary gout.
They are firm deposits of monosodium urate in crystal form, which
develop from pinhead-size to egg-size in the subcutaneous tissue. In
the field of ear, nose, and throat diseases tophi have been
described in such rare locations as the wing of the nose, the
tongue, the epiglottis, and the arytenoid and thyroid cartilage.
Tophus formation at the temporomandibular joint with extension into
the fossa infratemporalis has been mentioned only three times in the
world literature. -In the present paper, the authors report on the
extraordinary location of an urate tophus in the fossa
infratemporalis - in this case, there was even destruction of the
middle base of the skull - which had been misinterpreted for years,
having been diagnosed as a primary disease of the parotid gland.
A gouty tophus in
the temporomandibular joint and on the eustachian tube. Laryngol
Rhinol Otol (Stuttg).1983 Dec;62(12):574-7.
A 76-year
old female patient was suffering from a right-sided conduction-type
hearing loss due to a very painful tumour in the anterior parotid
region. X-ray films showed a partial destruction of the right
temporomandibular joint. Since the patient had undergone a
left-sided mastectomy for breast carcinoma two years previously, an
operation was performed under the suspicion of a metastatic lesion.
A plum-sized gouty tophus was found adjacent to the
temporomandibular joint. The head of the mandible was partly
destroyed, the upper pole of the parotid gland displaced and
atrophic. The dorsal and medial aspect of the tophus impinged on the
cartilaginous portion of the Eustachian tube. In the postoperative
course, the conduction-type deafness disappeared, the pain was
relieved, and the mobility of the joint almost completely restored.
To our knowledge this represents the second case of a gouty tophus
in the temporomandibular joint, the first one where the size of the
lesion resulted in impingement of the Eustachian tube and
conduction-type deafness. It is noteworthy that the patient showed
no other signs or symptoms of primary gouty arthritis.
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