Abstract
This study was to assess the effects of low dose immunosuppressive therapy on hearing in patients with steroid responsive autoimmune inner ear disease (AIED) and a Western blot assay positive for 68 kD inner ear antigen. We conducted retrospective analysis of 46 patients. 18 patients were treated with steroid alone and 28 patients were treated with steroid followed by a cytotoxic agent. Pure tone average (PTA) at 250Hz, 500Hz, 1 kHz, 2 kHz and 4 kHz were used as objective measures of outcome. At the completion of treatment, 20 of the 46 patients (43%) exhibited a positive response to therapy, 12 (26%) were stabilized and 14 (30%) were worsened. 26 of 69 affected ears (38%) were improved. 11 patients who were treated with steroid alone demonstrated improvement in 13 of 19 affected ears (68%). 9 patients who were followed by a cytotoxic-agent demonstrated improvement in 11 of 12 affected ears (82%).
We conclude that 24% of patients with steroid responsive AIED obtained a benefit from low dose corticosteroid therapy and that a cytotoxic medication appeared to improve in 32% of patients who fell responsive to corticosteroid therapy.
