Endocrine Abstracts

Acromegaly is associated with a range of comorbidities, including cardiovascular disease, diabetes, hypertension and sleep apnea. Bony overgrowth and soft tissue thickening not only cause typical external features of acromegaly, but also debilitating musculoskeletal aches. Recently, a few papers reported auditory complications of acromegaly, but there has been no report on narrowing of the external auditory canal as a complication of acromegaly. A 58-year-old acromegalic patient complained of fullness of both ears. He had transsphenoidal surgery for GH-secreting pituitary adenoma 17 years ago. Somatostatin analogue therapy was discontinued 2 years earlier, because nadir GH after oral glucose loading and IGF-1 level were normal. On laboratory exam, random GH was 0.82 ng/ml, and IGF-1 264.74 ng/ml (reference range, 71–263). On otolaryngologic examination, both auricles were very hard and immobile, and orifices of external auditory canals (EAC) showed slit-like openings. In left ear, eardrum examination was impossible due to severe stenosis of EAC. On temporal bone CT, both ears showed thickening of tympanic membranes and evidence of chronic otitis media with severe soft tissue thickening of left EAC. Pure tone audiometry documented mild hearing loss in left ear. The patient declined any further evaluation and therapeutic intervention. Ear complications of acromegaly has not received much attention so far. We report a case of ECA stenosis developed in an acromegalic patient, as a novel complication of acromegaly.