Sequential Bilateral Otitis Media and Bilateral Facial Nerve Paralysis as Presenting Symptoms of Wegener's Granulomatosis

Wegener's granulomatosis is an incurable vasculitis that can be life-threatening when end-organ damage occurs. Symptoms most commonly affect the nose, lungs, and kidneys. We present a case study of a 35-year-old male who presented with sequential bilateral otitis media, progressive mixed hearing loss, tinnitus, otalgia, otorrhea, and, later, bilateral facial nerve paralysis despite aggressive antibiotic inter- vention. The accompanying review of the literature demonstrates only six other patients worldwide with these presenting symptoms. Treat- ment options and outcome will be discussed.