a 54-year - old male patient consulted to our outpatient clinic with complaints of priorly swelling , erythema of the external ear , then eye redness , and arthralgia since 7 months . with time hearing loss it was learnt that the patient was treated with the diagnosis of corneal ulcer , and episcleritis . on her physical examination biochemical tests revealed increased sedimentation rate ( 58 mm / h ) , and crp level . ( 2.67 ) total ig e was 434 ku / l . on audiological examinations bilateral type a tympanogram pattern , sensorineural hearing loss of 51 db in the left , and of 43 db in the right ear was observed ( figure 2 ) . cutaneous , and subcutaneous tissue were quiet edematous , and helical cartilage was very fragile . the patient attended routine control visits , and his ear lobe gained its normal appearance at 6 . relapsing polychondritis is a multisystemic disease which courses with relapses , and causes progressive destruction of the cartilage tissue . although specific laboratory test for relapsing polychondritis is not available , most frequently increased sedimentation rate , and crp levels are observed . in 50% of the cases , thrombocytosis , leukocytosis , and normochromic normocytic anemia increased urinary levels of acid mucopolysaccharides , and in the blood samples antibodies developed against type 2 collagen can be detected . in our case , we typically detected increased sedimentation rate , and crp levels . diagnostic criteria include bilateral auricular chondritis , seronegative polyarthritis , nasal chondritis , ocular inflammation , respiratory system chondritis , and audiovestibular destruction . accordingly , positivity of at least three criteria or treatment response to steroids and/or dapsone , presence of chondritis in two or more than two different regions are sufficient to establish the diagnosis of relapsing polychondritis . articular , and ocular findings previously thought to be meaningless in most of the cases have been clearly understood to be the components of relapsing perichondritis when auricular perichondritis became manifest . our case was previously followed up with the diagnosis of episcleritis , however this symptom had not suggested the diagnosis of relapsing polychondritis . these symptoms regress spontaneously within days , rarely weeks , and relapses at varying intervals . at every episode cartilaginous conductive , and sensorineural hearing loss are seen in cases with relapsing polychondritis [ 4 - 6 ] . also in our case , in addition to histopathologic diagnosis , bilateral auricular chondritis , ocular findings , seronegative arthritis , sensorineural type hearing loss , and response to steroid therapy were detected . in 40% of the cases , mechanism of the destructive changes in the internal ear are not clearly known , but involvement of the internal ear with the inflammatory process has been implicated . though conductive type hearing loss is associated with serous otitis , and chronic otitis frequently secondary to involvement of the eustachian tube , it can be also related to the involvement of the external ear canal . in the treatment , treatment starts with initial daily loading dose of 15 mg / kg / day which is tapered stepwise , and prescribed based on the activity , and severity of the disease or it can be administered as a maintenance dose . in our case following a bolus dose of a steroid , dapsone , colchicine , and immunosuppressives can be also used for its treatment . in conclusion , this clinical condition which progresses with multisystem involvement , due to its characterization by audiologic findings , and especially involvement of the pinna can confront otorhinolaryngology specialists who usually make initial diagnosis .
relapsing polychondritis is a cartilage tissue disease characterized by inflammatory and destructive episodes . 
 elastic cartilage of the ear and nose , hyaline cartilage of the joints , hyaline cartilage of vertebra and trachea are the main involvement areas . also organs having proteoglycan structure such as eyes , heart , blood vessels , and the inner ear can be affected . in this article 
 otologic findings of a 54-year - old male patient with a diagnosis of relapsing polychondritis were presented and discussed in the light of the literature .