Ear disease in patients with Wegener's granulomatosis

From a group of 60 patients with histologically-proven Wegener's granulomatosis managed at the National Institute of Allergy and Infectious Disease, approximately 45% were found to have disease that involved the ears. The majority of these patients had either recurrent or persistent serous otitis, resulting from eustachian tube dysfunction as a consequence of nasopharyngeal inflammations. Other pathologies included suppurative otitis, cholesteatoma, facial nerve paralyses, temporal bone granulomata, and sensory hearing losses. The presentation and management of these changes and their relationships to underlying disease are described in selected case reports, and a general philosophy of patient management is presented.