{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:21:40Z","timestamp":1787314900825,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T00:00:00Z","timestamp":1543363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe a case series of previously undiagnosed granulomatosis with polyangiitis (GPA) patients who presented primarily with otological manifestations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>We report a series of patients visited at a neurotology clinic who were eventually diagnosed with GPA based on their otologic complaints and had no prior knowledge of having this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In this series, 10 (91%) patients presented with hearing loss (HL), more than half of which were bilateral (60%). Upon audiometric examination, all but 1 patient had mixed, conductive, or sensorineural HL. All patients presented with eustachian tube dysfunction (ETD), otitis media with effusion (OME), or both. Nasal endoscopy showed intranasal pathology in 3 (27%) patients. Otologic symptoms were improved in all patients after treatment with an average of 4 in-office follow-up appointments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>GPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003489418815517","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T00:50:56Z","timestamp":1543452656000},"page":"263-266","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations"],"prefix":"10.1177","volume":"128","author":[{"given":"Ronald","family":"Sahyouni","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"},{"name":"Department of Biomedical Engineering, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omid","family":"Moshtaghi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Abouzari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuonganh","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Birkenbeuel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dillon","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison W.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0281-6962","authenticated-orcid":false,"given":"Hamid R.","family":"Djalilian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, Irvine, CA, USA"},{"name":"Department of Biomedical Engineering, University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"bibr1-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.4.906"},{"key":"bibr2-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1590\/S0482-50042010000200005"},{"key":"bibr3-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(97)00133-1"},{"key":"bibr4-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390112"},{"key":"bibr5-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1177\/0394632015617063"},{"key":"bibr6-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2110-8"},{"key":"bibr7-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198302000-00020"},{"issue":"95","key":"bibr8-0003489418815517","first-page":"327","volume":"29","author":"Safavi Naini A","year":"2017","journal-title":"Iran J Otolaryngol"},{"key":"bibr9-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330807"},{"key":"bibr10-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"issue":"5","key":"bibr11-0003489418815517","first-page":"1025","volume":"28","author":"Harper SL","year":"2001","journal-title":"J Rheumatol"},{"key":"bibr12-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.3.241"},{"key":"bibr13-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1989.tb00403.x"},{"key":"bibr14-0003489418815517","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-98-1-76"},{"key":"bibr15-0003489418815517","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000868"},{"key":"bibr16-0003489418815517","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100302"}],"container-title":["Annals of Otology, Rhinology &amp; 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