Photoclinic Diagnosis : Wegener’s Granulomatosis with Bilateral Facial Nerve Palsy

A19-year-old girl presented to our outpatient clinic with a history of bilateral otalgia, purulent discharge from both ears, and progressive hearing loss. On examination, both tympanic membranes were multiply perforated with profuse mucopurulent discharge, and there was bilateral facial nerve palsy and hearing loss. Audiometric evaluation showed bilateral mixed hearing loss of 75 dB in the right ear and 90 dB in the left ear. A high-resolution computed tomography (CT) scan of the temporal bone revealed opacification of the mastoid without any bone destruction. The patient was hospitalized and received intravenous antibiotics. She had previously received antibiotics as an outpatient. No bacterial growth was obtained from culture of the ear discharge.