Publication:

Otorhinolaryngological manifestations in patients with hypothyroidism: a cross-sectional observational study

Background Hypothyroidism is a common endocrine disorder that frequently manifests with symptoms affecting the otorhinolaryngological (ENT) system. These symptoms are often under-recognized or misdiagnosed, leading to delayed management. This study aimed to evaluate the prevalence and types of ENT symptoms in patients with hypothyroidism and correlate these findings with thyroid hormone levels.

Methods A cross-sectional observational study was conducted in a tertiary care centre over 8 months, enrolling 200 adult patients diagnosed with primary hypothyroidism. Detailed ENT history and clinical evaluation were performed. Investigations included thyroid function tests, pure tone audiometry for patients with hearing complaints, and laryngoscopy for those with voice changes. Patients were categorized based on TSH levels into mild (4.5–10 mIU/l), moderate (10–20 mIU/l), and severe (>20 mIU/l) hypothyroidism.

Results Among 200 participants (mean age: 42.5±12.1 years; 70% female), 72% reported at least one ENT symptom. Hoarseness of voice (46.5%), nasal congestion (39%), and hearing loss (36%) were most common. Audiometry revealed sensorineural hearing loss in 62.9% and conductive loss in 37.1% of symptomatic patients. Laryngoscopic evaluation showed vocal cord edema in 72.3% cases. ENT symptom prevalence increased significantly with higher TSH levels (p<0.001).

Conclusions ENT manifestations are prevalent in hypothyroidism and correlate with disease severity. Early ENT evaluation and thyroid function testing can facilitate timely diagnosis and improve quality of life.