Pathology of Wegener's Granulomatosis (Granulomatosis with Polyangiitis) of the Ear
with Polyangiitis) is defined as a granulomatous inflammation of
the upper and lower respiratory tract and systemic vasculitis of
small and medium sized vessels which is often accompanied by a
The etiology of the disease is still unknown.
According to recent literature, involvement of the ears, nose, and throat can in many instances be the only early manifestation of the disease.
It is important that audiologists be aware of the early signs in order to make appropriate referral for treatment, particularly since they are usually among the first to see these patients.
Common sites of involvement include the middle ear, nose and sinuses and subglottis.
Granulomatous lesions in the nose, paranasal sinuses and pharynx are very characteristic and often mark the beginning of the disease.
Otologic manifestations of Wegener's Granulomatosis :
- A painful otitis media with combined sensorineural hearing loss may be the first sign of this disease in some cases ;
- Tympanic membrane perforation,
- Perforation of ear lobes,
- External otitis ,
Diagnosis is made by a combination of physical examination, laboratory studies and tissue biopsy.
Differential diagnosis: Rheumatoid arthritis ; polyarteritis nodosa.
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