A case of facial palsy as a initial sign of Wegener's granulomatosis

Wegener's granulomatosis (WG) is a multi-system disease characterized by granuloma formation and necrotizing vasculitis. It typically involves the upper and lower respiratory tract and kidney. Otologic involvement may occasionally be the initial symptom of WG. A case report of WG was described, which first presented as facial nerve palsy. The combination of facial nerve palsy, sensorineural hearing loss and otitis media was unusual. We should raise suspicion. Early diagnosis is vital if unnecessary surgical exploration is to be avoided. The diagnosis of a WG is made clinically based on clinical findings, histologic confirmation and titres of cytoplasmic pattern antineutrophil cytoplasmic autoantibodies (c-ANCA)/ Anti-proteinase 3 (Anti-PR3). Immunosuppressive therapy with steroids, cyclophosphamide (CTX) is required for relief. A delay in diagnosis may lead to devastating sequelae, such as facial nerve palsy and hearing loss. WG is a challenging disease for otorhinolaryngologist.PubMed04434-63