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Sarcoidosis of the Ear, Nose and Throat: a review of the literature
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  • Nicholas Cereceda-Monteoliva,
  • Maral Rouhani,
  • Elizabeth Maughan,
  • Anthony Rotman,
  • Nara Orban,
  • Chadwan Al Yaghchi,
  • Guri Sandhu
Nicholas Cereceda-Monteoliva
Imperial College Healthcare NHS Trust
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Maral Rouhani
Charing Cross Hospital
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Elizabeth Maughan
Charing Cross Hospital
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Anthony Rotman
Charing Cross Hospital
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Nara Orban
Barts Health NHS Trust
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Chadwan Al Yaghchi
Imperial College Healthcare NHS Trust
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Guri Sandhu
Imperial College Healthcare NHS Trust
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Abstract

Objectives. Sarcoidosis is a multisystemic inflammatory disease with extrathoracic manifestations, most commonly affecting the young and middle-aged, female and black populations. Diagnosis usually requires evidence of non-caseating granulomata and, when treated, prognosis is usually favourable. We aim to establish the incidence, clinical features and optimal treatment of ENT manifestations of this disease. Design. We performed a review of the literature to determine the evidence-base supporting this. Results. ENT manifestations are present in 10-15% of patients with sarcoidosis, often as a presenting feature, and require vigilance for swift recognition and coordinated additional treatment specific to the organ. Laryngeal sarcoidosis presents with difficulty in breathing, dysphonia and cough, and may be treated by Speech and Language Therapy (SLT) or intralesional injection, dilatation or tissue reduction. Nasal disease presents with crusting, rhinitis, nasal obstruction and anosmia, usually without sinus involvement. It is treated by topical nasal or intralesional treatments but may also require endoscopic sinus surgery, laser treatment or even nasal reconstruction. Otological disease is uncommon but includes audiovestibular symptoms, both sensorineural and conductive hearing loss, and skin lesions. Conclusions. The consequences of ENT manifestations of sarcoidosis can be uncomfortable, disabling and even life threatening. Effective management strategies require good diagnostic skills and use of specific therapies combined with established treatments such as corticosteroids. Comparisons of treatment outcomes are needed to establish best practice in this area.

Peer review status:ACCEPTED

04 Dec 2020Submitted to Clinical Otolaryngology
22 Dec 2020Submission Checks Completed
22 Dec 2020Assigned to Editor
04 Jan 2021Reviewer(s) Assigned
13 Mar 2021Review(s) Completed, Editorial Evaluation Pending
15 Mar 2021Editorial Decision: Revise Minor
26 Mar 20211st Revision Received
27 Mar 2021Submission Checks Completed
27 Mar 2021Assigned to Editor
13 Apr 2021Reviewer(s) Assigned
08 May 2021Review(s) Completed, Editorial Evaluation Pending
09 May 2021Editorial Decision: Accept