Petrified Ear in Adrenal Insufficiency: Systematic Literature Review

Area of Science:

• Endocrinology
• Otolaryngology
• Dermatology

Background:

• Adrenal insufficiency is a recognized condition associated with petrified ear.
• A systematic literature review was conducted to explore this association further.

Purpose of the Study:

• To investigate the characteristics and clinical presentation of petrified ear in patients with adrenal insufficiency.
• To differentiate the occurrence of petrified ear in primary versus central adrenal insufficiency.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Searched Excerpta Medica, PubMed, and Web of Science databases without language restrictions.
• Included studies reporting adrenal insufficiency and petrified ear, extracting demographic, clinical, and outcome data.

Main Results:

• Analyzed 40 cases from 36 reports, predominantly affecting adult males (38/40).
• Petrified ear was bilateral in all cases and occurred in both primary (18 cases) and central (20 cases) adrenal insufficiency.
• In primary adrenal insufficiency, petrified ear appeared ≥2 years post-diagnosis (72%); in central insufficiency, it was concurrent or prior to diagnosis (85%).

Conclusions:

• Petrified ear in adrenal insufficiency is consistently bilateral, affects adult males, and is observed in both primary and central forms.
• The timing of petrified ear detection differs between primary (later) and central (earlier/concurrent) adrenal insufficiency.
• Petrified ear associated with adrenal insufficiency does not improve with therapy and is not linked to hearing impairment.