Facial paralysis in Wegener's granulomatosis of the middle ear

A case of Wegener's granulomatosis. which presented as chronic otitis media with facial nerve palsy, is described. Early diagnosis is vital if unneces sary surgical exploration is to be avoided. A false negative cANCA may dela y the diagnosis, especially in cases of locoregional disease, and a policy of repeated titres should be adopted, if clinical suspicion is high.