(205) Autoimmune Disorders as Risk Factors for Otolaryngologic Disease and Head and Neck Cancer

Introduction: Autoimmune conditions are increasingly recognized for their systemic symptomology, with growing evidence that chronic inflammation and immune dysregulation is associated with a wide breadth of comorbidities. Specifically, there appears to be an association between various autoimmune conditions and the development of otolaryngologic conditions. This study seeks to examine the association between autoimmune disorders and incidence ENT manifestations including head and neck cancer development.

Methods: A multicenter retrospective cohort study was performed in the TriNetX database. Adult patients with common autoimmune conditions (systemic lupus erythematosus, rheumatoid arthritis, psoriasis, multiple sclerosis (MS)) were matched with controls (n=4,184-34,061 per cohort). Outcomes included ENT conditions (chronic rhinosinusitis (CRS), otitis media, sensorineural hearing loss (SNHL), tinnitus, vestibular disorders, dysphonia) and head/neck cancers (oropharyngeal, laryngeal, sinonasal, salivary, thyroid, lymphoma). Risk ratios with 95% CIs were calculated.

Results: Autoimmune cohorts had higher incidence across multiple ENT conditions. Vasculitis had an increase in CRS (RR 2.17, 95% CI [1.85-2.53]) and chronic/recurrent otitis media (RR 2.67,[2.15-6.64]). MS patients demonstrated higher facial nerve palsy (RR 3.78,[2.15-6.64] and vestibular disorders (RR 2.41,[1.71-3.40]). Lymphoma risk was increased in sarcoidosis (RR 2.35,[1.65-3.35]), and thyroiditis demonstrated an association with thyroid cancer (RR 2.34,[2.03-2.70]), as expected. The risk of other head and neck cancers was lower or unchanged across most cohorts.

Conclusions: Autoimmune disease was associated with increased incident otolaryngologic comorbid conditions. In contrast, most head/neck cancers were unchanged or decreased in autoimmune conditions. Our findings support increased clinical monitoring for ENT complaints in patients with autoimmune disease.