Abstract
Otitis media associated with ANCA vasculitis (OMAAV) is an intractable otitis media and difficult to diagnose. However, ANCA vasculitis is life threatening and early intervention is needed. There are several intractable otitis media which should be differentiated from OMAAV; eosinophilic otitis media, cholesterol granuloma, otitis media tuberculosa and so on. Here we propose the algorithm of differential diagnosis for OMAAV and the diagnostic tools such as serological test, cytology and radiological imaging.