title: Focus on audiologic impairment in eosinophilic granulomatosis with polyangiitis.
abstract: To evaluate the clinical features of audiologic impairment and its relationship with the nasal, vestibular, and rheumatologic profile in a cohort of patients with eosinophilic granulomatosis with polyangiitis (EGPA), formerly named Churg-Strauss syndrome.
  
  
  
  Prospective cross-sectional study.
  
  
  
  Thirty-nine patients with EGPA, considered controlled according to the Birmingham Vasculitis Activity Score and the Vasculitis Damage Index, underwent a complete audiologic evalutaion with otomicroscopy, impedance audiometry, speech audiometry, and auditory brainstem responses; rhinologic evaluation was made by means of fiberoptic endoscopy and nasal cytology; the clinical evaluation was completed with analysis of the facial function and, in patients with referred vertigo, with videonystagmography (VNG). Data were compared to the rheumatologic profile (eosinophil count, antineutrophil cytoplasmic antibodies status).
  
  
  
  Thirty-four of 39 patients fulfilled the inclusion criteria. Of those, 18 (52, 8%) were affected by variable degrees of hearing loss (sensorineural hearing loss [SNHL]) in four cases (11, 8%), mixed sensorineural and conductive hearing loss in two (5, 9%), presbycusis in six (17, 6%), and otitis media with effusion (OME) in six (17, 6%). Vestibular impairment was represented by benign paroxysmal positional vertigo and unspecific dizziness in three (8, 8%) and four cases (11, 8%), respectively, all with normal VNG. Ear involvement was statistically related to the EGPA vasculitic pattern and independent from the nasal impairment, cytology, and duration of nasal symptoms. No facial palsy was registered.
  
  
  
  In our experience, the largest in the existing literature, the otological involvement in EGPA is common and may occur variably as SNHL or OME. Otological involvement occurs early in the course of the disease process, but is nonspecific in making the diagnosis of EGPA. Its recognition is therefore fundamental.
  
  
  
  4. Laryngoscope, 126:2792-2797, 2016.
authors.affiliation: Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Seccia
authors.affiliation: Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Fortunato
authors.affiliation: Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Lodovica
authors.initials: L
authors.lastname: Cristofani-Mencacci
authors.affiliation: Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Dallan
authors.affiliation: Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Augusto P
authors.initials: AP
authors.lastname: Casani
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Latorre
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Paggiaro
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Bartoli
authors.affiliation: Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sellari-Franceschini
authors.affiliation: Rheumatology Unit, University of Pisa, Pisa, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Baldini
mesh_terms: D000328:Adult; D000368:Aged; D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000209:etiology; D011446:Prospective Studies; D014420:Turbinates / Q000473:pathology
keywords: Churg-Strauss syndrome; Eosinophilic granulomatosis with polyangiitis; chronic otitis media with effusion; sensorineural hearing loss; vasculitis