Severe vestibulocochlear involvement in Wegener's granulomatosis: a rare presentation.

We present the clinical case of 61-year-old female, lacking relevant antecedents, whose condition began with tinnitus and hearing loss of the right ear (RE). At 4 months she presented an episode of sudden vertigo, followed by continuous dizziness and imbalance. She received a diagnosis of otitis media with effusion (OME), but did not improve after various treatments. After that, she developed hearing loss of the left ear, with a sensation of fluctuating blockage, tinnitus and right facial paresis. One year later, the hearing loss had progressed toward bilateral cophosis and the imbalance worsened. However, the facial paralysis facial subsided. Otomicroscopy exploration: image compatible with OME. Ear and neurological examination: no spontaneous nystagmus, Halmagyi test with corrective ocular with saccades on both sides, instability in Romberg and Unterberger test, absence of response to caloric stimulation (even with ice water) and in the kinetic vestibular rotating chair test (at both low and intermediate frequencies), the patient presented only minimal response to high frequency stimulation, with a gain of merely 0.12--0.64 Hz of rotation. Imaging