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

Authors

  • Pratik Kumar Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
  • Swati Vashisth Department of Otorhinolaryngology, ESI Post Graduate Institute of Medical Education and Research, Basaidarapur, New Delhi, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20262382

Keywords:

Hypothyroidism, ENT, Hearing loss, Hoarseness, Laryngoscopy

Abstract

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.

References

Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39-51.

Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001;345:260-5.

Pearce EN, Farwell AP, Braverman LE. Hypothyroidism and the ear. Ann Otol Rhinol Laryngol. 2008;117:320-3.

Pradhan P, Sharma S, Adhikari P. ENT manifestations of hypothyroidism. Nepal J ENT Head Neck Surg. 2020;11:25-8.

Alam MA, Rahman MM, Hossain MA. Otolaryngologic manifestations in hypothyroid patients. J Clin Diagn Res. 2017;11:1-4.

Madani FM, Mahfouz ME, Alqahtani AS. Laryngeal changes in hypothyroid patients. Eur Arch Otorhinolaryngol. 2016;273:443-7.

Shetty D, Sreedharan S, Nair S. Nasal symptoms and thyroid dysfunction. Indian J Endocrinol Metab. 2014;18:143-5.

Anand VT, Mann SB, Dash RJ, Mehra YN. Hearing and hypothyroidism. Laryngoscope. 2001;111:652-5.

Shukla A, Misra R, Kumar K. Hypothyroidism and ENT correlation. Indian J Otolaryngol Head Neck Surg. 2012;64:293-6.

Bhatia PL, Gupta OP, Agrawal MK, Mishr SK. Audiologic studies in hypothyroid patients. J Laryngol Otol. 1977;91:393-6.

Gullu S, Sav H, Kamel N. Effects of hypothyroidism treatment on hearing function. Ann Otol Rhinol Laryngol. 2003;112:623-7.

Nanda S, Sharma R, Gupta A. Vestibular dysfunction in thyroid disease. J Otolaryngol Head Neck Surg. 2015;44:24.

Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Sleep Med. 2009;10:1106-10.

Gupta A, Singh V, Sharma P. Correlation of TSH levels with ENT manifestations in hypothyroidism. Indian J Otol. 2018;24:77-81.

Kaur M, Kaur G, Singh A. ENT profile in hypothyroidism patients: a clinical study. Int J Otorhinolaryngol Head Neck Surg. 2022;8:456-61.

Downloads

Published

2026-07-23

How to Cite

Kumar, P., & Vashisth, S. (2026). Otorhinolaryngological manifestations in patients with hypothyroidism: a cross-sectional observational study . International Journal of Otorhinolaryngology and Head and Neck Surgery, 12(4), 603–607. https://doi.org/10.18203/issn.2454-5929.ijohns20262382

Issue

Section

Original Research Articles