Bilateral Facial Palsy in Rapidly Progressive Course of Wegener’s Granulomatosis: A Case Report

Roszkowska, Anna M.; Morawska-Kochman, Monika; Temporale, Hanna; Sikorska-Żuk, Małgorzata; Kręcicki, Tomasz

doi:10.1155/2013/875108

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…Occasionally, the progressive course of the disease may lead to bilateral facial palsy, which was observed in our patient. Bilateral facial palsy is an extremely rare finding [19]. In the review of 2856 patients with facial paralysis Lee et al reported only 2% of cases with bilateral involvement [20].…”

Section: Discussionmentioning

confidence: 99%

“…Many authors recommend conservative treatment, as it usually results in nerve function recovery, whereas surgery may increase the risk of additional nerve injury [14, 19]. However, unusual manifestation at the onset of the disease may delay the correct diagnosis and the suspicion of GPA only appears in the case of failure of conventional therapy or when additional symptoms from other organs occur.…”

Section: Discussionmentioning

confidence: 99%

“…If untreated, the disease may be lethal. In such case, 80–82% of patients die within 1 year after diagnosis [19]. Approximately 25% of patients present a fulminant course of the disease with multiple organs involvement and subsequent failure [2].…”

Section: Discussionmentioning

confidence: 99%

“…Our patient evolved this way, with the disease running rapidly fatal course leading to death within 2 years from the initial otological symptoms. Preuss et al [9] presented similar case of patient with GP-induced bilateral facial palsy together with renal and pulmonary involvement, which despite intensive treatment had a fatal course due to multiorgan failure [19]. The average survival of patients with GPA is 5 months [19].…”

Section: Discussionmentioning

confidence: 99%

“…Preuss et al [9] presented similar case of patient with GP-induced bilateral facial palsy together with renal and pulmonary involvement, which despite intensive treatment had a fatal course due to multiorgan failure [19]. The average survival of patients with GPA is 5 months [19]. However, prompt initiation of suitable treatment may result in long-term remissions in up to 90% of patients, especially before renal involvement [14].…”

Section: Discussionmentioning

confidence: 99%

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Granulomatosis with Polyangiitis with Bilateral Facial Palsy and Severe Mixed Hearing Loss

Wawrzecka

Szymańska

Jeleniewicz

et al. 2016

Case Reports in Otolaryngology

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Granulomatosis with polyangiitis is autoimmune and rare disease. It affects many organs, but the most often affected organs are the nose, lungs, and kidneys. It is part of vasculitis and causes an autoimmune attack by an abnormal type of circulating antibody termed ANCAs against small blood vessels. Disease concerns both men and women with a peak age of presentation in the sixth and seven decades. Typically upper and lower respiratory tract and kidneys are involved. Otitis externa, otitis media, or mastoiditis rarely occurs in granulomatosis with polyangiitis. Deafness is the most dangerous aural complication. Histological examination of biopsy is often not specific. A case of GPA with bilateral otitis media, bilateral deafness, and bilateral facial palsy with fatal course is presented.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Granulomatosis with Polyangiitis with Bilateral Facial Palsy and Severe Mixed Hearing Loss

Wawrzecka

Szymańska

Jeleniewicz

et al. 2016

Case Reports in Otolaryngology

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An Interesting Case of Bilateral Facial Palsy due to Granulomatosis with Polyangiitis

Shil

Teir

2021

Case Reports in Rheumatology

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Granulomatosis with polyangiitis (formerly called Wegener’s granulomatosis) is a systemic autoimmune disease, which can lead to necrotizing vasculitis affecting small vessels and cause inflammation of blood vessels in the nose, sinuses, throat, lungs, and kidneys. In rare instances, it has shown involvement of the brain and cranial nerves as well. We are reporting a case of granulomatosis with polyangiitis, complicated by bilateral facial palsy due to lower motor neuron involvement of the facial nerve, which has responded well to immunosuppressive treatment, particularly rituximab. It is prudent to be vigilant in investigating patients with atypical presentation for systemic autoimmune diseases, as this approach would affect the patient morbidity and mortality with early initiation of treatment for the disease.

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Residual cholesteatoma of the temporal bone in a patient with granulomatosis with polyangiitis

Osipova,

Kosyakov,

Pchelenok

et al. 2024

Medicinskij sovet

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A case of residual temporal bone cholesteatoma in a patient with granulomatosis with polyangiitis (Wegener) (GPA) is presented. At the onset of the disease, the patient developed a symptom complex, which included, along with sinonasal manifestations, left-sided purulent otitis media, refractory to traditional therapy. A separate atticoanthrotomy on the left temporal bone, performed in the active phase, before the diagnosis of vasculitis, did not lead to a clinical improvement in the condition of the middle ear. Despite the subsequent implementation of adequate immunosuppressive therapy and drug remission of GPA, the continuously recurrent course of purulent otitis media of the operated ear contributed to the development of residual cholesteatoma of the temporal bone with the spread of the process to surrounding structures. The presence of cholesteatoma was confirmed by MRI of the temporal bones in the non-EPI DWI mode. During the period of drug remission of GPA, repeated sanitizing surgery was performed on the middle ear with tympanoplasty and obliteration of the parathympanic spaces, which made it possible to achieve remission of purulent otitis media. The development of residual middle ear cholesteatoma in a patient with GPA could be due to the untimely initial diagnosis, the late onset of specific immunotherapy, the rapidly progressive and recurrent nature of the course of the disease, and surgical treatment in the phase of high disease activity. The insufficient volume of primary surgical treatment contributed to the formation of laced cavities and the development of residual cholesteatoma of the temporal bone. The use of MRI in the non-EPI DWI mode for diagnosis made it possible to identify the development of cholesteatoma of the left temporal bone in a patient with GPA and track the results of surgical treatment in the postoperative period. The non-EPI DWI MRI method proved effective both for detecting temporal bone cholesteatoma and tracking changes in the postoperative period of a patient with GPA. Tympanoplasty with surgical obliteration of the parathympanic spaces allowed to stop the inflammation of the middle ear in a patient with a systemic autoimmune disease.

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Bilateral Facial Palsy in Rapidly Progressive Course of Wegener’s Granulomatosis: A Case Report

Cited by 4 publications

References 13 publications

Granulomatosis with Polyangiitis with Bilateral Facial Palsy and Severe Mixed Hearing Loss

Granulomatosis with Polyangiitis with Bilateral Facial Palsy and Severe Mixed Hearing Loss

An Interesting Case of Bilateral Facial Palsy due to Granulomatosis with Polyangiitis

Residual cholesteatoma of the temporal bone in a patient with granulomatosis with polyangiitis

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