Kusaka Iori, Ikeda Ryoukichi, Katsura Aya, Shiga Kiyoto
Department of Otolaryngology, Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, JPN.
Cureus. 2024 Feb 5;16(2):e53677. doi: 10.7759/cureus.53677. eCollection 2024 Feb.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a systemic necrotizing vasculitis that affects small to medium-sized vessels. We describe two cases of patulous Eustachian tube (PET) in patients with otitis media with ANCA-associated vasculitis (OMAAV). The two cases presented in this paper had previously been diagnosed with Eustachian tube (ET) stenosis, and both presented with bilateral aural fullness, with one also experiencing postnasal drip and hearing loss. Both patients experienced positive myeloperoxidase (MPO)-ANCA and negative proteinase 3 (PR3)-ANCA, and treatment for ANCA-associated vasculitis (AAV) resulted in a diagnosis of PET. The patients were treated with transnasal self-installation of physiological saline into the pharyngeal orifice of the ET. This paper highlights the importance of considering PET in the differential diagnosis of OMAAV patients presenting with aural fullness.
抗中性粒细胞胞浆抗体(ANCA)相关性血管炎是一种影响中小血管的系统性坏死性血管炎。我们描述了两例患有ANCA相关性血管炎伴中耳炎(OMAAV)的患者出现咽鼓管异常开放(PET)的病例。本文介绍的这两例患者先前被诊断为咽鼓管(ET)狭窄,均表现为双侧耳闷,其中一例还伴有鼻后滴漏和听力损失。两名患者的髓过氧化物酶(MPO)-ANCA均为阳性,蛋白酶3(PR3)-ANCA均为阴性,针对ANCA相关性血管炎(AAV)的治疗导致了PET的诊断。患者接受了经鼻向ET咽口自行滴注生理盐水的治疗。本文强调了在对出现耳闷的OMAAV患者进行鉴别诊断时考虑PET的重要性。