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Original Articles
June 1961

Otologic Manifestations of Fatal Granulomatosis of Respiratory Tract: Lethal Midline Granuloma— Wegener's Granulomatosis

Arch Otolaryngol. 1961;73(6):639-643. doi:10.1001/archotol.1961.00740020653003

The purpose of this paper is to describe the otologic features of fatal granulomatosis of the respiratory tract. Particular emphasis is placed upon the pathologic anatomic findings as seen in serial sections of the paired temporal bones of 2 patients with this disease.

Clinical Findings  Detailed clinical data concerning the University of Michigan Medical Center patients and selected cases from the literature have been presented previously.1-12 The clinical otologic findings in this report are based upon a study of 18 patients of 124 previously reported, or 14.5% of total cases (Table). Five cases are from the University of Michigan series. The findings are essentially those of chronic middle ear and mastoid suppuration, often the result of salpingitis observed with nasopharyngeal granuloma formation. As is characteristic of Wegener's lethal midline granuloma complex in general, the otitic disease failed to respond to the conventional conservative or surgical therapeutic methods. In one

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