What Is Autoimmune Inner Ear Disease?

Autoimmune inner ear disease is limited autoimmune damage, which usually lasts for several weeks to several years, and has fluctuating unilateral or bilateral sensorineural hearing loss. Examinations indicate hearing impairments of cochlea, postcochlear, or both. May be accompanied by tinnitus, dizziness, serum immunological parameters such as tissue non-specific antibodies, anti-inner ear tissue-specific antibodies are positive, and some patients are also accompanied by arthritis, vasculitis, glomerulonephritis and other immune diseases. High-dose steroids and immunosuppressants are effective for this disease.

Autoimmune inner ear disease

Description of autoimmune inner ear disease

Autoimmune inner ear disease is limited autoimmune damage, which usually lasts for several weeks to several years, and has fluctuating unilateral or bilateral sensorineural hearing loss. Examinations indicate hearing impairments of cochlea, postcochlear, or both. May be accompanied by tinnitus, dizziness, serum immunological parameters such as tissue non-specific antibodies, anti-inner ear tissue-specific antibodies are positive, and some patients are also accompanied by arthritis, vasculitis, glomerulonephritis and other immune diseases. High-dose steroids and immunosuppressants are effective for this disease.

Clinical manifestations of autoimmune inner ear disease

Often middle-aged patients (mostly women); bilateral ear asymmetry or unilateral rapid progressive, fluctuating hearing loss, pure tone audiometry, acoustic impedance, otoacoustic emissions, cochlear electrogram, abr Hearing tests include snail or post-snail hearing loss; may be accompanied by tinnitus, dizziness, and pressure in the ear; may be accompanied by other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and cogan syndrome Etc .; the course is longer and can last for weeks, months or years. For suspected patients, you can go to the hospital to test immunological parameters, such as tissue non-specific antibodies, anti-inner ear tissue-specific antibodies, lymphocyte subsets, leukocyte migration inhibition tests, lymphocyte transformation tests, etc., as well as serum immunoglobulins and erythrocyte sedimentation. Tests such as rheumatoid factor and CIC also have certain reference values, but if these test results are positive, they have important reference values for diagnosis, such as negative, and cannot be ruled out.

Diagnosis of autoimmune inner ear disease

(1) Whole body examination: Focus on the eyes, neck, circulatory system and nervous system that can cause dizziness.

(2) ENT examination: focus on the middle ear and inner ear for inflammatory diseases.

(3) Auditory examination: tuning fork experiment, pure tone lateral listening, speech audiometry, acoustic impedance test, cochlear point diagram and auditory brainstem response (ABR)

(4) Vestibular function test: spontaneous nystagmus, gait test, position test. The nystagmus (dual temperature test) and rotation test can understand the amount and nature of vestibular function loss. Elderly nystagmus slow phase rate, frequency amplitude and nystagmus value gradually weakened. The cold stimulus response is small, and the above parameters of the thermal stimulus response are weakened significantly.

(5) Imaging examination: X-ray of ear, tomography of ear and cervical vertebra, thin layer of temporal bone or skull (CT scan, magnetic resonance of skull or cervical spine, transcranial color Doppler, to understand inner auditory canal, skull Internal and cervical conditions.

(6) Laboratory examinations: EEG, ECG, radionuclide examination, hemorheology, blood biochemical and allergy examination, understanding of brain, heart, liver, kidney function and immune function.

Treatments for autoimmune inner ear disease

in case:

1) Symptoms improve after medication, symptoms worsen after discontinuation, and symptoms improve again after medication;

2) Symptoms of decrement worsen and symptoms of decrement improve;

It can be considered that the experimental treatment is effective and supports the diagnosis of autoimmune inner ear disease. However, when autoimmunity is at an advanced stage, the effect is poor because the inner ear disease is irreversible.