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Ear involvement in ligneous conjunctivitis: a rarity or an under-diagnosed condition?
Dag Hydén1, Stefan Latkovic, Ulf Brunk
1Department of Otorhinolaryngology, University Hospital, Linköping, Sweden. dag.hyden@lio.se
The Journal of Laryngology and Otology
|October 19, 2002
Summary
Conjunctivitis lignosa can affect the middle ear, presenting as atypical otitis media. Early diagnosis via biopsy and specific glycosaminoglycan staining is crucial for effective treatment.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Histopathology
Background:
- Conjunctivitis lignosa is a rare conjunctival disorder.
- It can be associated with other systemic or localized disturbances.
- Concurrent conjunctivitis lignosa and ear involvement is infrequently reported.
Observation:
- Two pediatric cases of conjunctivitis lignosa with histopathologically verified middle ear involvement are presented.
- Ligneous changes in the middle ear mimicked secretory otitis media with effusion.
- The amorphous, cell-deficient material showed specific glycosaminoglycan staining patterns.
Findings:
- Histochemical and immunohistochemical studies revealed significant accumulations of hyaluronic acid and keratin sulfate in affected conjunctival and middle ear tissues.
- Other glycosaminoglycans like chondroitin-4-sulfate and dermatan sulfate were localized to vascular and stromal components.
- Findings were consistent with typical ligneous conjunctivitis histopathology.
Implications:
- Ear involvement in conjunctivitis lignosa may be underdiagnosed due to its similarity to common otitis media.
- Biopsies with specific staining for hyaluronic acid and keratin sulfate are recommended for refractory otitis media cases.
- This approach can aid in diagnosing rare cases of conjunctivitis lignosa with otic manifestations.