Vasculitis and the ear: a literature review

Purpose of review Systemic vasculitides as a group of inflammatory disorders of blood vessels may show clinical manifestations in the ear. This article reviews the recent literature about vasculitis of the ear or the cochleovestibular system, focusing on giant-cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, microscopic polyangiitis, granulomatosis with polyangiitis (GPA), eosinophilic GPA, systemic lupus erythematosus, Cogan's syndrome and Behcet's disease. Recent findings In patients with vasculitis, hearing impairment is a frequent problem, followed by tinnitus and vertigo. The severity of sensorineural hearing loss can range from mild impairment to deafness. Autoimmune diseases can induce a conductive hearing loss as a result of effusions of the middle ear, the inflammation of the mucosa of the Eustachian tube, or the involvement of the ossicular chain. Vertigo may be caused by the temporary or permanent occlusion of the labyrinthine or the anterior vestibular artery. Middle ear inflammation is frequent in GPA and eosinophilic GPA. The progressive sensorineural hearing loss in polyarteritis nodosa or Cogan's syndrome patients may be treated by cochlear implantation.