A Case of Petrified Auricles in a Patient with Adrenal Insufficiency

Petrified ear is a rare condition characterized by calcification or ossification of the auricular cartilage. It has been associated with trauma and systemic endocrinopathies such as diabetes mellitus, hypothyroidism, and adrenal insufficiency. Here, we present a case of a 59 year-old male with adrenal insufficiency for over 25 years who developed symptomatic bilateral petrified ears. The patient presented with a seven year history of progressive bilateral otalgia, auricular stiffening, and subjective hearing loss. He had significant discomfort when contacting his ears, preventing him from wearing hats, headphones, or lying on his side. Physical examination demonstrated bilateral, symmetric, rigid and tender auricles without overlying skin changes. The otoscopic exam was unremarkable. Audiometry showed a mild bilateral sensorineural hearing loss. Computed tomography showed bilateral auricular cartilage calcifications without other abnormalities. Serum calcium levels were normal. A diagnosis of petrified ears was made and attributed to his adrenal insufficiency. The patient was counseled on protective measures to reduce trauma and discomfort and referred to endocrinology to address the underlying adrenal pathology. Although petrified ears are frequently asymptomatic, symptomatic cases can have serious consequences for patient quality of life. Endocrine pathologies are often associated with this condition. The pathophysiology is poorly understood, and there is limited evidence on the reversibility of petrified ears, even with adequate management of an underlying endocrine disorder. This case highlights the importance of recognizing symptomatic petrified ear and considering systemic causes, particularly adrenal insufficiency, in affected individuals.