Our patient meets criteria for AAV and her clinical presentation—upper airway and middle ear involvement with saddle-nose deformity, recurrent nosebleeds, bilateral chronic serous otitis media and conductive hearing loss, abnormal CT showing cavitary lesions, and PR3 and C-ANCA positivity—is most consistent with GPA [18]. This evidence concerns the gene PRTN3 and granulomatosis with polyangiitis.