[Cochlear implantation in patients with autoimmune hearing loss].

HNO

Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland.

Published: April 2024

AI Article Synopsis

  • Autoimmune inner ear disease (AIED) leads to fluctuating hearing loss and may require cochlear implants (CIs) for rehabilitation, but treatment can affect results.
  • A case study of a 25-year-old male showed that after receiving a CI, his hearing impedances fluctuated significantly, particularly with the use of the TNFα inhibitor adalimumab.
  • The findings suggest that maintaining immunomodulatory therapy is important for stabilizing hearing outcomes in AIED patients with CIs, as it can help reduce impedances and improve overall hearing quality.

Article Abstract

Background: Autoimmune inner ear disease (AIED) manifests with recurrent fluctuating sensorineural hearing loss and vestibular symptoms. Treatment includes steroids and a variety of immunosuppressants. Despite adequate treatment, sensorineural hearing loss can be progressive to the point of deafness. In these patients, a cochlear implant (CI) is indicated. We present the case of a 25-year-old male who underwent cochlear implantation in the left ear. After implantation we noticed brisk variations in impedances which were related to application of the previously prescribed tumor necrosis alpha (TNFα) inhibitor adalimumab.

Objective: Can immunomodulatory therapy in AIED patients after CI fitting affect the quality of hearing rehabilitation?

Materials And Methods: We documented impedances and speech intelligibility (Freiburg monosyllable test) of our patient for 1 year in dependence on adalimumab therapy.

Results: Directly after implantation, impedances were within the normal range. During the further course, impedances started to rise, and recurrent adjustments of the implant were needed. Adalimumab therapy was reinitiated, which resulted in a subsequent reduction of impedances.

Conclusion: Cochlear implantation can be necessary in some AIED patients and poses a sufficient method for hearing rehabilitation. Depending on the activity of the underlying disease, a rise in impedances may occur. Immunomodulatory treatment may therefore be necessary to maintain adequate hearing results with the CI.

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Source
http://dx.doi.org/10.1007/s00106-024-01472-5DOI Listing

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