Involvement of the external ear is rare.
Involvement of the middle ear is found in about 40-70% of the
patients. The most common form of presentation in
WG is otitis media with effusion, can be either unilateral or bilateral,
probably occurring secondary to eustachian tube obstruction from
luminal granulomata or from nasopharyngeal inflammation and ulceration.
An infection caused by S. aureus and Pseudomona aeruginosa is
frequently found, partially complicated by multi-resistances.
Cranial nerve palsies, most commonly the facial nerve and
meningitis are possible.
Sensorineural hearing loss occurs with a reported frequency of
5-31% in WG. Proposed causes include immune-complex deposition
in the cochlea, granulomatous compression of the cochlear
nerve, and vasculitis of the vasa nervorum or the cochlear vessels.