• Noam Bartov, Tzofit Dahan, Doron Halperin, and Udi Katzenell.
• Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
• Isr Med Assoc J. 2022 Dec 1; 25 (12): 834835834-835.

BackgroundGranulomatosis with polyangiitis (GPA) otologic manifestations include conductive and sensorineural hearing loss (HL). Vasculitis is assumed to be the primary cause of otologic manifestations. Deaf patients and patients with HL who do not benefit from hearing aids can benefit from cochlear implants (CI). There are currently no specific guidelines for treatment of patients with GPA suited for CI.ObjectivesTo assess whether patients who are deaf due to GPA are good candidates for CI and if prior surgical or medical treatment of the inflammation are needed.MethodsA case report is presented.ResultsA 71-year-old female patient with GPA and bilateral profound HL underwent CI. Prior to CI, preparation consisted of audiological evaluations by an otolaryngologist and a rheumatologist, followed by a course of prednisone and methotrexate for middle ear and nasal inflammations. CI was performed with no complications. The speech reception threshold and the monosyllabic word discrimination score after surgery were 25 dBHL and 75%, respectively.ConclusionsInflammation due to GPA can be controlled medically with immunosuppressive medications without subtotal petrosectomy, as in chronic suppurative otitis media. Satisfactory audiological results can be expected.

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