title: Vestibular Involvement in Patients With Otitis Media With Antineutrophil Cytoplasmic Antibody-associated Vasculitis.
abstract: Otitis media (OM) with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is a novel concept of ear disease that is characterized by progressive mixed or sensorineural hearing loss with occasional systemic involvement. Considering the accumulating knowledge about the characteristics of and treatment for auditory dysfunction in OMAAV, the objective of this study was to investigate the vestibular function and symptoms of patients with OMAAV.
  
  
  
  Retrospective chart review.
  
  
  
  University hospital.
  
  
  
  Thirty-one OMAAV patients met criteria proposed by the OMAAV study group in Japan.
  
  
  
  Clinical characteristics and vestibular tests.
  
  
  
  Eleven of 31 OMAAV patients had vestibular symptoms; 3 patients had acute vertigo attack with sudden hearing loss and 8 patients had chronic dizziness. Episodic vertigo was not seen in any of the patients. Three patients who received a less intensive therapy without immunosuppressive agents developed intractable persistent dizziness. All symptomatic patients and six of the nine OMAAV patients without vestibular symptoms showed unilateral or bilateral caloric weakness; therefore, vestibular involvement was present in 84% of OMAAV patients. Gain of vestibulo-ocular reflex was reduced in symptomatic patients. The eye-tracking test and optokinetic nystagmus revealed no evidence of central dysfunction.
  
  
  
  Vestibular dysfunction was seen in 84% of OMAAV patients. One-third of OMAAV patients showed vestibular symptoms such as acute vertigo attack or chronic dizziness, which are of peripheral origin. One-third of the symptomatic patients developed intractable dizziness. Initial intensive treatment by combination therapy with steroid and immunosuppressive agents may be essential for preventing the development of intractable dizziness.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Morita
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Shuji
authors.initials: S
authors.lastname: Izumi
authors.forename: Yamato
authors.initials: Y
authors.lastname: Kubota
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Ohshima
authors.forename: Arata
authors.initials: A
authors.lastname: Horii
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies; D015837:Vestibular Diseases / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents