Polyarteritis nodosa: a human temporal bone study

Joglekar, Shruti; Deroee, Armin Farajzadeh; Morita, Norimasa; Cureoglu, Sebahattin; Schachern, Patricia A.; Paparella, Michael

doi:10.1016/j.amjoto.2009.02.006

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 31, Issue 4 , Pages 221-225, July 2010

Polyarteritis nodosa: a human temporal bone study☆

Shruti Joglekar, MD
- Otitis Media Research Center, Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
- International Hearing Foundation, Minneapolis, MN 55455, USA
Armin Farajzadeh Deroee, MD
- Otitis Media Research Center, Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
- International Hearing Foundation, Minneapolis, MN 55455, USA
Norimasa Morita, MD, PhD
- Otitis Media Research Center, Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
- International Hearing Foundation, Minneapolis, MN 55455, USA
Sebahattin Cureoglu, MD
- Otitis Media Research Center, Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
Patricia A. Schachern, BS
- Otitis Media Research Center, Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
- Corresponding author. Room 226, Lions Research Building, 2001 6th Street S.E., Minneapolis, MN 55455, USA.
Michael Paparella, MD
- Otitis Media Research Center, Department of Otolaryngology, University of Minnesota, Minneapolis, MN 55455, USA
- Paparella Ear, Head and Neck Institute, Minneapolis, MN 55455, USA

Received 20 May 2008 published online 18 May 2009.

Abstract

Purpose

Polyarteritis nodosa is one of the common forms of vasculitis with multiorgan involvement. Hearing loss may be the presenting symptom of this disease. The aim of this histopathologic study was to evaluate temporal bone changes in polyarteritis nodosa and assess the correlation between otologic manifestations and histopathologic findings.

Materials and methods

A retrospective human temporal bone analysis was performed at an otopathology laboratory in a tertiary academic medical center. Three cases (5 temporal bones) with pathologically confirmed diagnosis of polyarteritis nodosa were selected for study. The processed temporal bone sections were studied under light microscopy.

Results

Two of the 3 cases presented with hearing loss, and one of them had facial palsy. Audiometric data available for one patient demonstrated a bilateral, rapidly progressive, mixed hearing loss. Histopathologically, we found generalized vasculitis involving small- and medium-sized arteries in all cases. Of the 5 temporal bones available for study, 3 had chronic otitis media and 2 had serous otitis media. Arteritis was seen in all middle ears. There was disruption of the organ of Corti and spiral ganglion cells in 4 temporal bones. One temporal bone showed fibrosis and osteogenesis in the scala tympani of the basal turn. Vasculitis of stylomastoid and branches of labyrinthine artery were also found in temporal bones.

Conclusions

Significant temporal bone findings were seen in patients with polyarteritis nodosa, including otitis media, cochlear damage, neo-osteogenesis, and middle and inner ear vasculitis. This temporal bone series also suggests an interesting relationship between sensorineural hearing loss and labyrinthine vasculitis.