[Serous otitis and necrotizing angiitis].
Three cases are reported of necrotizing angiitis of otologic origin (one polyarteritis nodosa and two wegener's disease). Data in the published literature are reviewed and necrotizing angiitis classified. Two features resulting from this review are emphasized. Firstly, form the pathogenic point of view the fact that specific lesions were detected in the ear in one of these patients means that this localization may be a possible visceral manifestation, as are rhinologic and pulmonary lesions. Otologic sites may be an isolated, or in association, further type of pathogenic mechanism. From the practical point of view, any unexpected serous otitis in adults should suggest the need for an erythrocyte sedimentation test, very high values requiring investigation of etiology. This will avoid unnecessary medical and surgical treatments and the institution of immunosuppressant therapy active against all visceral lesions and the only effective means of treating the otitis. Early treatment could avoid the catastrophic prognosis observed short-term in the 3 cases reported.