2015 Volume 25 Issue 2 Pages 202-207
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) presents the otologic symptom as an initial symptom. In this study, audiological features and hearing outcome after immunosuppressive therapy were evaluated. A total 284 cases 480 ears audiologically evaluated at pre- and post-treatment in the nationwide surveys were enrolled in this study.
Hearing outcomes were compared among the following factors: 1. hearing loss type (conductive, sensorineural or mixed), 2. otitis media type (secretion or granulation), 3. ANCA subtype, 4. another organ involvements (nose, lung, facial palsy, hypertrophic pachymeningitis), 5. immunosuppressive therapy; prednisolone (PSL) only or PSL and cyclophosphamide(CPA). The overall hearing outcome was as follows: complete recovery in 30%, partial recovery (<10dB) in 30%, no change or worse in 40%. The completely deaf could not be recovered. The hearing outcome of ANCA negative group showed worse than that of another group. No significant difference of hearing recovery among nose, lung involvement. On the other hand, the patients combined with facial palsy showed significantly worse hearing outcome compared with no facial palsy patients. Patients treated by the immunosuppressive therapy with both PSL and CPA showed significantly better hearing outcome compared with PSL only (odds ratio 2.21).