Wegener's granulomatosis: presentation as an otologic problem.

Presentation of Wegener's granulomatosis as an otologic problem is unusual and leads to incorrect diagnosis and unsuccessful therapy. In seven years, five patients with a diagnosis of otitis media failed to respond to the usual therapeutic regimens. All had surgical manipulations on the middle ear or mastoid, or both. Wegener's granulomatosis was suspected because of persistence of the otologic problem. All patients developed pulmonary lesions and had positive diagnoses by biopsy of either the lung, kidney, or upper respiratory mucosa. Withe timely treatment, all patients have survived.