PATHOLOGY OF ELASTIC CARTILAGE IN THE EPIGLOTTIS AND AURICLE
Abstract
Background. The purpose of this study was to define the pathological changes of some lesions of the elastic cartilage of the epiglottis of the larynx and the auricle and to consider their pathogenesis.
Methods. Surgical histological material was examined from one patient with pseudocyst of the epiglottis, one with pseudocyst of the auricle of the ear and four with chondrodermatitis nodularis helicis, in one of whom the lesion was bilateral.
Results. The pseudocyst of the epiglottis was situated between the anterior and posterior surfaces of that organ. In the anterior region of the epiglottic cartilage, but not the posterior, perichondrium was fibrotic, and chondrocytes and elastic fibres were markedly reduced. There were similar changes in relation to the auricular cartilage pseudocyst. In the auricles with chondrodermatitis the changes were those of focal necrosis of the rim of the cartilage at the helix with associated acute inflammation, ulceration and hyperplasia of the overlying epidermis. In one lesion necrotic cartilage had been extruded and lay on the floor of the ulcer. Thickening of the walls of small arteries was seen near the perichondrium of the heliceal region.
Conclusions. The patient with pseudocyst of the epiglottis had severe gastro-oesophageal reflux which had necessitated recent gastric surgery. The acid reflux may have caused perichondrial ischaemia of the anterior epiglottic cartilage resulting in the pseudocyst. The auricular pseudocyst was associated with similar focal perichondrial damage on one surface only, probably caused by trauma. Chondrodermatitis nodularis helicis is likely produced by ischaemia of perichondrium at the poorly vascularized helix
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