Vol.97 No.8 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 97 No. 8 August 2004
Wegener's Granulomatosis of the Ear: Case Report
Mizuho Yagisawa
(Yokohama City University Medical Center)
Junichi Ishitoya and Yasunori Sakuma
(Yokohama City University Medical Center)
Takafumi Yoshida
(Yokohama City University School of Medicine)
Mamoru Tsukuda
(Yokohama City University, Graduate School of Medicine)
Wegener's granulomatosis is a rare autoimmune disease affecting predominantly the nose or paranasal sinuses. Other organs of the upper air way may, however, be involved either alone or as parts of generalized disease. Occasionally the otological manifestation is the first and only sign of Wegener's
granulomatosis.
In this case report we describe Wegener's granulomatosis in a 43-year-old female who complained of right aural discharge. Treatment for otitis media with systemic antibiotics was not effective, and due to persistent headache accompanied by mixed hearing loss, mastoidectomy was performed two months after the initial presentation. Histological examinations revealed granulomatous tissue in the mastoid, showing non-specific granulomatous inflammation. After operation, she developed painful gingival swelling and nasal obstruction. Finally, the patient was diagnosed with Wegener's granulomatosis based on the clinical, histological, and laboratory findings.
Since it is often difficult to confirm the diagnosis histologically, especially in limited types of Wegener's granulomatosis, we consider it better to rely on a test for C-ANCA when positive histological findings are not observed in the biopsy specimens.
The diagnosis should be considered in patients with otitis media that are unresponsive to conventional treatment.
Key words : Wegener's granulomatosis, otitis media, C-ANCA