Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes

Abstract Objectives To assess outcomes following cochlear implantation (CI) in patients with hearing loss secondary to primary or secondary autoimmune inner ear disease (AIED). Methods A systematic review and narrative synthesis was completed according to PRISMA guidelines. Databases searched includ...

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Main Authors: Jonathan Lee, Kirsty Biggs, Jameel Muzaffar, Manohar Bance, Peter Monksfield
Format: Article
Language:English
Published: Wiley 2021-06-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.563
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author Jonathan Lee
Kirsty Biggs
Jameel Muzaffar
Manohar Bance
Peter Monksfield
author_facet Jonathan Lee
Kirsty Biggs
Jameel Muzaffar
Manohar Bance
Peter Monksfield
author_sort Jonathan Lee
collection DOAJ
description Abstract Objectives To assess outcomes following cochlear implantation (CI) in patients with hearing loss secondary to primary or secondary autoimmune inner ear disease (AIED). Methods A systematic review and narrative synthesis was completed according to PRISMA guidelines. Databases searched included MEDLINE, PubMed, EMBASE, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits were placed on year of publication or language. Results A total of 551 studies were identified, of which 29 were included after removal of duplicates, and screening the title, abstract, and full text. All except one study were OCEBM grade IV. 114 of 115 patients displayed improvement in hearing following cochlear implantation. With implant use, roughly a third of these patients had hearing that improved over time, a third improved and plateaued, and a third remained stable. There was no additional risk of perioperative complications found in AIED patients compared what is generally accepted in general cochlear implantation, although two episodes of device failure after 6 months were noted, and four patients with secondary AIED displayed poor initial audiological outcomes. Conclusion CI in both primary and secondary AIED provides marked improvement in hearing. Early CI may be a valid management option, provide long‐lasting hearing in patients and reduce the side effects of long‐term systemic immunosuppressants. However, patients should be counseled residual hearing may be lost if there is cochlear ossification or fibrosis which may make implant insertion more traumatic. Level of Evidence NA.
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spelling doaj.art-4d9ca7e40e8c4140b200aca0e5c0d61f2022-12-21T19:24:30ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-06-016346948710.1002/lio2.563Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomesJonathan Lee0Kirsty Biggs1Jameel Muzaffar2Manohar Bance3Peter Monksfield4South Warwickshire Foundation Trust Warwick UKUniversity Hospitals of North Midlands Stoke‐on Trent UKUniversity Hospitals Birmingham NHS Foundation Trust Birmingham UKUniversity of Cambridge Cambridge UKUniversity Hospitals Birmingham NHS Foundation Trust Birmingham UKAbstract Objectives To assess outcomes following cochlear implantation (CI) in patients with hearing loss secondary to primary or secondary autoimmune inner ear disease (AIED). Methods A systematic review and narrative synthesis was completed according to PRISMA guidelines. Databases searched included MEDLINE, PubMed, EMBASE, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits were placed on year of publication or language. Results A total of 551 studies were identified, of which 29 were included after removal of duplicates, and screening the title, abstract, and full text. All except one study were OCEBM grade IV. 114 of 115 patients displayed improvement in hearing following cochlear implantation. With implant use, roughly a third of these patients had hearing that improved over time, a third improved and plateaued, and a third remained stable. There was no additional risk of perioperative complications found in AIED patients compared what is generally accepted in general cochlear implantation, although two episodes of device failure after 6 months were noted, and four patients with secondary AIED displayed poor initial audiological outcomes. Conclusion CI in both primary and secondary AIED provides marked improvement in hearing. Early CI may be a valid management option, provide long‐lasting hearing in patients and reduce the side effects of long‐term systemic immunosuppressants. However, patients should be counseled residual hearing may be lost if there is cochlear ossification or fibrosis which may make implant insertion more traumatic. Level of Evidence NA.https://doi.org/10.1002/lio2.563autoimmune inner ear diseaseCochlear implantssensorineural hearing losssystematic review
spellingShingle Jonathan Lee
Kirsty Biggs
Jameel Muzaffar
Manohar Bance
Peter Monksfield
Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes
Laryngoscope Investigative Otolaryngology
autoimmune inner ear disease
Cochlear implants
sensorineural hearing loss
systematic review
title Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes
title_full Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes
title_fullStr Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes
title_full_unstemmed Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes
title_short Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post‐cochlear implantation outcomes
title_sort hearing loss in inner ear and systemic autoimmune disease a systematic review of post cochlear implantation outcomes
topic autoimmune inner ear disease
Cochlear implants
sensorineural hearing loss
systematic review
url https://doi.org/10.1002/lio2.563
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AT kirstybiggs hearinglossininnerearandsystemicautoimmunediseaseasystematicreviewofpostcochlearimplantationoutcomes
AT jameelmuzaffar hearinglossininnerearandsystemicautoimmunediseaseasystematicreviewofpostcochlearimplantationoutcomes
AT manoharbance hearinglossininnerearandsystemicautoimmunediseaseasystematicreviewofpostcochlearimplantationoutcomes
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