Department of Otorhinolaryngology, Head & Neck Surgery.
Department of Internal Medicine, Martin Luther University Halle-Wittenberg, University Medicine Halle, Germany.
Curr Opin Rheumatol. 2020 Jan;32(1):47-52. doi: 10.1097/BOR.0000000000000665.
Systemic vasculitides as a group of inflammatory disorders of blood vessels may show clinical manifestations in the ear. This article reviews the recent literature about vasculitis of the ear or the cochleovestibular system, focusing on giant-cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, microscopic polyangiitis, granulomatosis with polyangiitis (GPA), eosinophilic GPA, systemic lupus erythematosus, Cogan's syndrome and Behçet's disease.
In patients with vasculitis, hearing impairment is a frequent problem, followed by tinnitus and vertigo. The severity of sensorineural hearing loss can range from mild impairment to deafness. Autoimmune diseases can induce a conductive hearing loss as a result of effusions of the middle ear, the inflammation of the mucosa of the Eustachian tube, or the involvement of the ossicular chain. Vertigo may be caused by the temporary or permanent occlusion of the labyrinthine or the anterior vestibular artery. Middle ear inflammation is frequent in GPA and eosinophilic GPA.
The progressive sensorineural hearing loss in polyarteritis nodosa or Cogan's syndrome patients may be treated by cochlear implantation.
系统性血管炎作为一组血管炎症性疾病，可能在耳部出现临床表现。本文回顾了有关耳部或耳蜗前庭系统血管炎的最新文献，重点关注巨细胞动脉炎、Takayasu 动脉炎、多发性大动脉炎、川崎病、显微镜下多血管炎、肉芽肿性多血管炎（GPA）、嗜酸性粒细胞性 GPA、系统性红斑狼疮、Cogan 综合征和贝赫切特病。
在血管炎患者中，听力障碍是一个常见问题，其次是耳鸣和眩晕。感音神经性听力损失的严重程度可从轻度损害到耳聋。自身免疫性疾病可因中耳积液、咽鼓管黏膜炎症或听骨链受累而导致传导性听力损失。眩晕可能是由于迷路或前前庭动脉的暂时性或永久性闭塞引起的。在 GPA 和嗜酸性粒细胞性 GPA 中，中耳炎症很常见。
多动脉炎或 Cogan 综合征患者进行性感音神经性听力损失可通过耳蜗植入治疗。
