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Autoimmune Inner Ear Disease: Steroid and Cytotoxic Drug Therapy
Journal article   Open access   Peer reviewed

Autoimmune Inner Ear Disease: Steroid and Cytotoxic Drug Therapy

John M. Lasak, Robert T. Sataloff, Mary Hawkshaw, Thomas E. Carey, Karen M. Lyons and Joseph R. Spiegel
Ear, nose, & throat journal, v 80(11), pp 808-822
Nov 2001
DOI: https://doi.org/10.1177/014556130108001110
PMID: 11816893
url
https://doi.org/10.1177/014556130108001110View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

The goal of this study was to assess the effects of immunosuppressive therapy on hearing inpatients with presumed autoimmune sensorineural hearing loss (AISNHL) and a Western blot assay positive for a 68 kD inner ear antigen. To achieve this objective, we conducted a retrospective review of 39 such patients who were treated with either a steroid alone or with a steroid followed by a cytotoxic agent. Pure-tone average (PTA) at 500 Hz, 1 kHz, 2 kHz, and 3 kHz and speech discrimination scores (SDS) were used as objective measures of outcome. At the completion of treatment, 23 of the 39 patients (59.0%) exhibited a positive response to therapy. The steroid-only responders (n = 6) tended to demonstrate a greater improvement in PTA (14.8 vs 4.5 dB), while the cytotoxic-agent responders (n = 17) had a significantly greater improvement in SDS (26.2 vs 6.9%; p< 0.01). We conclude that most patients with AISNHL benefit from immunosuppressive therapy and that cytotoxic medications appear to improve SDS, even in some patients who have not responded to corticosteroid therapy.

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