2019 Volume 29 Issue 1 Pages 45-51
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis affecting small-sized vessels of the lungs and nervous system. However, otologic presentations are often dominant early in the course of EGPA, making it difficult to differentiate EGPA from eosinophilic otitis media (EOM). Here we demonstrate a case of EGPA showing otitis media as the major symptom, and statistically compare clinical profiles of EGPA and EOM. Results revealed that the most typical otologic manifestation of EGPA is chronic otitis with granulating inflammation mainly affecting the posterior part of the meatus and ear drum. Gadolinium-enhanced 3D fast spoiled gradient-recalled imaging indicated the presence of posterior auricular arteritis as a potential etiology of granulomatous otitis of EGPA. However, vestibular examinations, including vestibular evoked myogenic potential, indicated the involvement of other vessels in the inner ear. Unlike EOM, peripheral neuropathy, facial nerve paresis and eosinophilia were specific to EGPA.
