A Rare Case of Granulomatosis With Polyangiitis (Wegener’s Granulomatosis) Presenting With Otologic Symptoms and Facial Paralysis

Granulomatosis with polyangiitis (GPA) is an uncommon disorder that causes inflammation of the blood vessels in the nose, throat, lungs, and kidneys. We describe a 20-year-old female who presented to the emergency room with acute left facial paralysis, worsening left-sided otalgia secondary to a hyperemic tympanic membrane with middle ear granulation tissue, nasal obstruction with associated intermittent epistaxis, and cough. A high index of suspicion for GPA helped make an early diagnosis with subsequent initiation of treatment. This case details an unusual presenting symptom for GPA, as well as our treatment plan and the patient's subsequent recovery.