Otolaryngological disturbances in Waldenstrom's macroglobulinaemia.

Four cases of Waldenstrom's macroglobulinaemia (WM) are described in which otoloaryngeal symptoms were present. Symptoms in WM are related to (a) bleeding diathesis and (b) hyperviscosity of the blood. The bleeding diathesis was manifested as epistaxis in 2 cases. In one case which came to postmortem, histological examination of the temporal bone showed complete disruption of the labyrinth by haemorrhage. Hyperviscosity probably was the source of hearing loss which took place in all 4 patients and had the following characteristics: (a) sudden onset (b) cochlear type (c) bilateral (d) sequential involvement of the two sides (e) improvement on treatment of the disease with alkylating agents or plasmapheresis. Early diagnosis of WM is thus important.