Secondary Adrenal Insufficiency Presenting as Petrified Ear Accompanied by Patulous Eustachian Tube: A Novel Combination

Petrified ear, characterized by auricular cartilage ossification, is a rare condition often associated with underlying endocrinopathies. We report a unique case of a 31-year-old male presenting with bilateral petrified ear accompanied by patulous Eustachian tube (PET), both manifestations of previously undiagnosed secondary adrenal insufficiency. The patient presented with progressive auricular rigidity, hearing impairment, and symptoms of PET including autophony. Endocrinological evaluation revealed central adrenal insufficiency, and the temporal bone CT demonstrated ossification of both auricular and Eustachian tube cartilage. Following the initiation of steroid replacement therapy, endocrinological parameters improved, and unexpectedly, the patient’s hearing thresholds also showed improvement at one-year follow-up. This case highlights the importance of comprehensive endocrinological evaluation in patients with petrified ear and represents the first reported association between petrified ear and PET, suggesting the need for vigilant otologic assessment in such cases.