Mastoidite e paralisia facial como manifestações iniciais de Granulomatose de Wegener

• Autor(a) principal: Maranhão, André Souza de Albuquerque [UNIFESP]
• Data de Publicação: 2012
• Outros Autores: Chen, Vitor Guo [UNIFESP], Rossini, Bruno Almeida Antunes [UNIFESP], Testa, Jose Ricardo Gurgel [UNIFESP], Penido, Norma de Oliveira [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S1808-86942012000200013; http://repositorio.unifesp.br/handle/11600/7059
• topic: facial paralysis; mastoiditis; Wegener Granulomatosis; Granulomatose de Wegener; mastoidite; paralisia facial

Wegener's Granulomatosis (WG) is characterized by necrotizing granulomas and vasculitis. If left untreated, the prognosis is poor - a 90% mortality rate within 2 years. Several authors have described the otologic manifestations of WG; these authors, however, have not mentioned the stage of the disease in which these findings present - whether as initial manifestations or subsequent to other findings. Aim: To describe three confirmed cases of WG with mastoiditis as the first manifestation, progressing to peripheral facial paralysis (PFP). Material and Method: A clinical series study. Patients diagnosed with WG that initially presented with otologic findings are described. Results: The three cases presented with unilateral otalgia, otorrhea, and hearing loss associated with ipsilateral PFP. None recovered in spite of the treatment; an investigation of associated diseases was therefore undertaken. Positive ANCA-C titers where detected in all patients, confirming the diagnosis of WG. Clinical improvement was seen after treatment of WG; the PFP regressed and hearing thresholds improved partially. Conclusion: Complications of otitis media (mastoiditis and PFP) that do not respond to the usual treatment require an investigation of associated diseases; WG should be included for an early diagnosis to change the prognosis in these patients.