Otorhinolaryngological manifestations in patients with eosinophilic granulomatosis with polyangiitis in a single university center.

Objectives: Eosinophilic granulomatosis with polyangiitis (EGPA) is an ANCA-associated vasculitis affecting multiple systems, with common ear, nose and throat (ENT) manifestations. This study aimed to evaluate the most frequent ENT manifestations in EGPA patients and the relationship between nasal polyps and other clinical findings such as ANCA tests and eosinophilia.

Materials and methods: A retrospective observational study was conducted on EGPA patients diagnosed between 2000 and 2024 at a tertiary hospital using the 2022 ACR/EULAR criteria. Head and neck examinations, including audiometry, and their imaging and histopathological studies were reviewed. Patients were classified based on the presence or absence of nasal polyps, and the relationship between ANCA positivity and eosinophilia was assessed.

Results: Of 173 patients with ANCA vasculitis, 22 met EGPA criteria, with a prevalence of 3.6 per 100,000 in Cantabria. Head and neck manifestations were observed in 90.5% of patients (19/21). Sinonasal involvement was the most frequent (82%), with otological manifestations in 31.8% (7/21). Nasal polyps were the most common manifestation (7/21). Head and neck biopsies were performed in 7 cases (32%), which showed no evidence of vasculitis. There was no statistically significant association between nasal polyps, ANCA positivity, and eosinophilia.

Conclusions: Sinonasal involvement is prevalent in EGPA, often presenting as chronic rhinitis or rhinosinusitis with or without polyps. Otological issues, such as eustachian tube dysfunction and sensorineural hearing loss, are also common. No laryngeal, oral, or salivary gland lesions were observed. There was no significant correlation between the presence of polyps and ANCA positivity or eosinophilia.