Sensorineural hearing loss in Wegener's granulomatosis--cytotoxic chemotherapy.

Dear Sir, We believe the article by Clements et al. in the May issue of the JLO to be misleading, in suggesting that the improvement in sensorineural hearing loss in Wegener's granulomatosis treated with combined cytotoxicimmunosuppressive therapy is an unusual finding. In the discussion they state there has been only one similar report (Peiterson and Carlsen, 1965). However, we should like to draw attention to two publications indicating that improvement is found in the majority of patients. McCaffrey et al. (1980) report nine patients with sensorineural hearing loss of which five had complete or partial recovery with combined treatment. Ilium and Thorling (1982), who were primarily interested in conductive loss, also record improvement in 'nearly all' in the series of thirteen patients of whom 'most had major sensory hearing loss'. Improvement in sensorineural hearing loss is therefore to be expected with combined cytotoxic-immunosuppressive therapy. Yours faithfully, G. E. Murty J. P. Birchall Freeman Hospital High Heaton Newcastle upon Tyne NE7 7DN.